C-Arm for accurate reduction of zygomatic arch fracture — A case report

Abstract

Fracture of the zygomatic arch is usually treated using blind methods. As the fracture lines cannot be visualised directly in closed reduction, digital exploration and crepitus noise or conventional radiographic imaging are used clinically as a guide to reposition the fragments. Successful closed reductions are often difficult to evaluate clinically because of the great amount of swelling that often accompanies these fractures. Postoperative radiographs are often the only way to assess the adequacy of the reduction. This article describes a technique that uses the C-Arm to quickly and accurately evaluate the reduction intraoperatively so that appropriate corrections can be made. A case report of a patient who suffered a w-shaped depressed fracture of the left zygomatic arch and zygomatico-maxillary complex fracture is presented.

C-Arm-Guided Reduction of Zygomatic Fractures Revisited

“…11 This system also involves little or no additional cost because of its wide availability in trauma centers and does not necessarily require operation by a radiologic technologist. 12,21 Mini portable fluoroscopy 8,22 offers more mobility and a lower risk of radiation exposure than the C-arm 23 but is less widely available 12 and likely unable to provide a bilateral zygomatic view.…”

“…The C-arm technique used was closely similar to that previously reported by Badjate and Cariappa. 11 Irradiation was directed from the submental area to the vertex toward the affected arch tangentially, allowing the zygomatic frame to be clearly viewed. The infraorbital rim, zygomaticofrontal suture, and zygomaticomaxillary buttresses were exposed via subciliary or subtarsal, lateral eyebrow, and gingivobuccal sulcus incisions, respectively.…”

“…Griffin et al 9 provided the first description of this technique in the treatment of an isolated zygomatic arch fracture in 1997, but this and the several articles appearing from then have scarcely focused on combined fractures. 11,12 Here, we prospectively evaluated C-arm-guided reduction in surgery for combined zygomatic fractures.…”

A Rare Case of Concrescence of Impacted Maxillary Molars

“…Even after complete eruption, they present correctly. Badjate and Cariappa [17] point to the possibility of concrescence that may complicate endodontic, orthodontic, prosthetic and surgical treatment. Partial diagnosis and not informing the patient about this anomaly prior to a surgical procedure may even have legal repercussions [17].…”

“…Badjate and Cariappa [17] point to the possibility of concrescence that may complicate endodontic, orthodontic, prosthetic and surgical treatment. Partial diagnosis and not informing the patient about this anomaly prior to a surgical procedure may even have legal repercussions [17]. The presence of an impacted tooth on an orthopantomographic image alone, does not, in many cases, cause suspicion of concrescence with the neighboring tooth [10].…”