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A Geometric, Biomechanical, and Surgical Analysis

Marc S. Karlan, MD; Nicholas J. Cassisi, DDS, MD

Arch Otolaryngol. 1979;105(6):320-327.

Abstract
• We present a four-part study of the cosmetic results of common zygomatic fracture reduction techniques: (1) a geometric analysis of an idealized paper and clay model; (2) a topographic analysis of zygomatic fractures in the dry skull; (3) a biomechanical analysis of fixation techniques in the fresh cadaver; and (4) a retrospective and prospective review of our clinical experience. The following are concluded: Alignment of the fracture at three points and fixation at two stable points provide the most accurate and satisfactory postoperative results. Masseteric contraction may cause late displacement in poorly fixed fractures. Two-point interosseous fixation at the "buttress" fracture and the frontozygomatic fracture is suitable for routine surgery. The infraorbital rim may be aligned through the gingivobuccal sulcus incision. Transcutaneous incisions may be limited to the brow incision. The transconjunctival approach is suitable for orbital floor repair.

(Arch Otolaryngol 105:320-327, 1979)

Author Affiliations
From the Division of Otolaryngology, University of Florida College of Medicine, Shands Teaching Hospital and Veterans Administration Hospital, Gainesville, Fla.

Footnotes
Accepted for publication April 5, 1978.

Presented at the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Inc, Boston, May 14, 1977.

Reprint requests to Box J-264, J. Hillis Miller Health Center, Gainesville, FL 32610 (Dr Karlan).

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