Depressed fractures of the zygomatic arch can be treated by several techniques, and the Gillies approach seems to be the one most commonly used in the U.S. and elsewhere. The presenter’s favorite technique, however, is the use of an ordinary large towel clip that is placed percutaneously through two small stab incisions that allow the tines to close together at a position medial to the central apex of the displacement of the two bone fragments. The towel clip is then locked and the fracture is reduced through the application of a firm, steady pull on the towel clip. The stab incisions are closed with dissolving suture and no special dressing is needed. Advantages of the towel clip over Gillies are many, including vastly reduced operating time, minimal post-op pain and swelling, ability to accomplish this under local anesthesia if desired and suitability for performance as an office procedure.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Describe a unique treatment option to patients with depressed zygomatic arch fractures.
Demonstrate when to offer treatment under local anesthesia.
Explain how to offer treatment in the more cost-effective environment of the OMS office, when appropriate.