Objective
To demonstrate the persistent malar displacement and distraction of the zygomatic-sphenoid fracture line that is possible after alignment of the frontozygomatic and infraorbital rim fractures of a displaced malar fracture.
Design
Nonblinded cadaver study.
Subjects
Three fresh cadaver heads and 1 representative clinical example.
Intervention
The cadaver heads were subjected to blunt trauma to the malar eminence. Reduction of the malar unit was performed either with attention to the frontozygomatic and infraorbital rim fractures alone or with concomitant inspection of the zygomatic-sphenoid fracture line. The representative case was repaired with a transconjunctival approach for inspection of the zygomaticsphenoid fracture line.
Results
Persistent malar asymmetry is possible after the reduction of displaced malar fractures when only the frontozygomatic and infraorbital rim buttresses are used for reference. In each case in our study, the zygomatic-sphenoid fracture line remained distracted. Alignment of the zygomaticsphenoid fracture restored premorbid malar position.
Conclusion
Inspection of the zygomatic-sphenoid fracture line can contribute significantly to the precise 3-dimensional reduction of displaced malar fractures.
Arch Otolaryngol Head Neck Surg. 1997;123:1308-1311
