C-Arm Guided Reduction of Isolated Zygomatic Arch Fractures

Background: The accurate surgical reduction of fractures is optimally performed by visualizing fracture displacement; however, the reduction of zygomatic arch fractures is typically accomplished using closed reduction. Anatomic reduction can be assured using only postoperative radiographs, thus causing intraoperative uncertainty. Aims and Objectives: This article introduces intraoperative C-arm guided reduction for assessing zygomatic arch fractures to assure the anatomic reduction of fracture displacement. Materials and Methods: Our hospital treated 261 patients for zygomatic bone fractures from 2002 to 2012; 32 of the patients exhibited isolated zygomatic arch fractures. Unstable fractures that exhibited severe comminution or torn periostea requiring internal or external fixation were excluded. Before operation, associated injuries, such as head and C-spine injuries, were meticulously evaluated and excluded. To prevent inadequate reduction of arch fracture displacement, Gillies reduction was performed using a C-arm guide and spare-hand palpation. Postoperative zygomatic bone X-rays were assessed to confirm the results of using the C-arm. Results: Most of the zygomatic arch fracture displacements attained anatomic reduction; however, approximately 10% of the arch fractures attained no anatomical reduction. Only one case demonstrated no obvious reduction after the operation, which was performed 2 weeks after injury. Conclusion: The intraoperative C-arm guided reduction of zygomatic arch fractures can assure the anatomic reduction of arch fracture displacements.