PORTABLE FLUOROSCOPY IN THE MANAGEMENT OF ZYGOMATIC ARCH FRACTURES

Operative methods that do not allow intraoperative visualization of th e fracture fragments in patients with isolated zygomatic arch fracture s often result in inadequate reduction. This article describes a techn ique using a portable, surgeon-operated fluoroscopic machine that can be used preoperatively, intraoperatively, and postoperatively in patie nts with isolated zygomatic arch fractures. Using the portable fluoros copic unit, reduction of isolated zygomatic arch fractures was perform ed in 9 consecutive patients over a period of 1.5 years. Postoperative alignment was confirmed using computed tomography (CT). These CT imag es were compared with the fluoroscopic images in several of the patien ts. Eight of the nine fractures were reduced via an intraoral approach and one through a Gillies approach. All nine fractures were easily vi sualized and their reductions were confirmed with intraoperative dynam ic visualization using a portable fluoroscopic unit. Postoperative CT revealed images of the reduction that were comparable with intraoperat ive and postoperative fluoroscopic images. The use of portable fluoros copy intraoperatively allows for dynamic visualization of instrumentat ion and the immediate confirmation of the adequacy of fracture reducti on. Moreover, this technique may eliminate the need for postoperative CT in isolated zygomatic arch fractures. Portable fluoroscopy may also have a place in the management of certain zygomatic complex fractures .