There are various types of arch fractures in zygomatic bone fractures. The average follow-up period was one year and two months ( Table 1). The shortest follow-up period was one month, and the longest was two years and five months. Among the accompanying fractures, tripod fractures formed the largest portion, with 32 cases followed by orbital floor fractures, with 11 cases mandible fractures, with 2 cases and 7 cases of nasoorbitoethmoidal and frontal bone fractures. As to the cause of injury, traffic accidents formed the largest portion, with 14 cases followed by falls, with 12 cases slipping, with 8 cases blunt trauma, with 4 cases and physical assault, with 2 cases. There were no patients with fractures in both sides. There were 22 cases of left sagittal fractures at the temporal root of the zygomatic arch and 18 cases of right sagittal fractures at the temporal root of the zygomatic arch. There were 34 male subjects and 6 female subjects. The age of the subjects ranged from 22 to 76 with a mean of 43.4. All of the patients were asked to wear arch protectors for three weeks after the surgery to prevent them from receiving additional injuries or damages on the operated sites.Īmong the patients who underwent facial bone fracture surgery, 40 patients were confirmed to have had sagittal fractures at the temporal root of the zygomatic arch. They were instructed not to eat hard foods but only a soft diet for about two weeks after they were discharged from the hospital. Postoperative liquid diets were provided to the patients for a week. The sagittal fracture cases at the temporal root of the zygomatic arch were followed up without direct reduction. Closed reduction was performed using the Gillies approach for complex fractures of the zygomatic arch, while the sagittal fracture site at the zygomatic process of the temporal bone was observed only without performing open reduction and fixation. In order to expose the fragments of the complex zygomatic-orbital-maxillary fracture site, subciliary, subbrow, temporal, and gingivobuccal approaches were used, while a two- or three-point fixation was performed using absorbable plates (Biosorb, Conmed, NY, USA). In all cases, surgery was performed under general anesthesia between 5 and 14 days after the injuries were received. This allowed us to propose possible treatment guidelines for sagittal fractures at the temporal root of the zygomatic arch. Through this comparative study, the authors evaluated the effect of indirect reduction on the sagittal fracture at the temporal root of the zygomatic arch. A follow-up was done to examine the radiologic decrease in bone gap and bony protrusion in the zygomatic arch sagittal fracture site without reduction and fixation, as well as the contour and symmetry of the zygomatic arch on the intact side. For the zygomatic arch, a closed reduction was performed using a classic Gillies approach, while the sagittal fracture site of the temporal root of the zygomatic arch was clinically observed without open reduction or fixation. Using classic two- or three-point fixation, the fracture sites were stabilized. Therefore, reported herein is a study on sagittal fractures at the temporal root of the zygomatic arch in patients with an accompanying zygomatic-orbital-maxillary fracture. Accordingly, few studies on sagittal fractures at the temporal root of the zygomatic arch have been performed. This area, however, is difficult to access, and fixation is limited by the important structures around the area. When a sagittal fracture occurs, reduction may likewise be necessary in other areas. The fracture at this area is originated from the zygomatic process of the temporal bone. In this study, cases of traumatic sagittal fractures at the temporal root of the zygomatic arch, which resulted from severe posterior and lateral displacements, were reviewed. Therefore, an accurate diagnosis, appropriate reduction of fracture fragments, and rigid fixation are required. Serious functional or aesthetic problems may arise depending on the treatment results. As a prime point of fracture alignment, it plays an important role in reduction. The zygomatic arch, important for midfacial area symmetry and has a protruded structure which is particularly vulnerable to fracture. Accompanying a growth in population and the increase in incidents such as violence and traffic accidents, the frequency of facial bone fractures has also increased.
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