TRANSSINUS REDUCTION AND ONE-POINT FIXATION OF MALAR FRACTURES

Objective: To describe and evaluate transsinus reduction and one-point miniplate fixation of the zygomaticomaxillary buttress for the treatm ent of tripod malar fractures. Design: A consecutive case series. Sett ing: Private otolaryngology practice. Patients: A consecutive sample o f 17 patients presenting with isolated tripod malar fractures over a 4 2-month period. Intervention: A gingivobuccal sulcus incision is made. Access into the maxillary sinus was obtained through an invariably co mminuted inferior fracture line. The zygoma was reduced by applying la teral and anterior traction force to the zygomatic recess of the maxil lary sinus. Miniplate fixation of the zygomaticomaxillary buttress are a was then performed bridging over an area of bone loss and comminutio n. Main Outcome Measures: Clinical assessment of facial symmetry by pa tients, physician, and roentgenographic studies. Results: All patients presenting with no comminution of the orbital rim had complete restor ation of their premorbid facial symmetry. One of the two patients pres enting with comminuted orbital rim had poor results. Conclusions: This technique is simple,limited, and successfuI in treating most malar fr actures. The lack of comminution of the orbital rim is crucial. for th e stability of the reduced zygoma. A simple and clinically relevant cl assification of malar fractures is proposed.