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Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture

BACKGROUND: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fract...

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Autores principales: Yoon, Hyungwoo, Kim, Jiye, Chung, Seum, Chung, Yoon-Kyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Cleft Palate-Craniofacial Association 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556815/
https://www.ncbi.nlm.nih.gov/pubmed/28913192
http://dx.doi.org/10.7181/acfs.2014.15.2.59
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author Yoon, Hyungwoo
Kim, Jiye
Chung, Seum
Chung, Yoon-Kyu
author_facet Yoon, Hyungwoo
Kim, Jiye
Chung, Seum
Chung, Yoon-Kyu
author_sort Yoon, Hyungwoo
collection PubMed
description BACKGROUND: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture. METHODS: We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria. RESULTS: We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method. CONCLUSION: We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.
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spelling pubmed-55568152017-09-14 Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture Yoon, Hyungwoo Kim, Jiye Chung, Seum Chung, Yoon-Kyu Arch Craniofac Surg Original Article BACKGROUND: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture. METHODS: We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria. RESULTS: We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method. CONCLUSION: We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device. The Korean Cleft Palate-Craniofacial Association 2014-08 2014-08-14 /pmc/articles/PMC5556815/ /pubmed/28913192 http://dx.doi.org/10.7181/acfs.2014.15.2.59 Text en © 2014 The Korean Cleft Palate-Craniofacial Association http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yoon, Hyungwoo
Kim, Jiye
Chung, Seum
Chung, Yoon-Kyu
Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title_full Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title_fullStr Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title_full_unstemmed Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title_short Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture
title_sort effectiveness of dual-maneuver using k-wire and dingman elevator for the reduction of unstable zygomatic arch fracture
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556815/
https://www.ncbi.nlm.nih.gov/pubmed/28913192
http://dx.doi.org/10.7181/acfs.2014.15.2.59
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