M. Tarabichi, TRANSSINUS REDUCTION AND ONE-POINT FIXATION OF MALAR FRACTURES, Archives of otolaryngology, head & neck surgery, 120(6), 1994, pp. 620-625
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.