The zygomatic-sphenoid fracture line in malar reduction. A cadaver study.
OBJECTIVE
To demonstrate the persistent malar displacement and distraction of the zygomatic-sphenoid fracture line that is possible after alignment of the frontozygomatic and infraorbital rim fractures of a displaced malar fracture.


METHODS
Nonblinded cadaver study.


METHODS
Three fresh cadaver heads and 1 representative clinical example.


METHODS
The cadaver heads were subjected to blunt trauma to the malar eminence. Reduction of the malar unit was performed either with attention to the frontozygomatic and infraorbital rim fractures alone or with concomitant inspection of the zygomatic-sphenoid fracture line. The representative case was repaired with a trans-conjunctival approach for inspection of the zygomatic-sphenoid fracture line.


RESULTS
Persistent malar asymmetry is possible after the reduction of displaced malar fractures when only the frontozygomatic and infraorbital rim buttresses are used for reference. In each case in our study, the zygomatic-sphenoid fracture line remained distracted. Alignment of the zygomatic-sphenoid fracture restored premorbid malar position.


CONCLUSIONS
Inspection of the zygomatic-sphenoid fracture line can contribute significantly to the precise 3-dimensional reduction of displaced malar fractures.
Burns
J A
JA
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical Center, Charlottesville, USA.
Park
S S
SS
D000328:Adult; D002102:Cadaver; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D015051:Zygomatic Fractures / Q000601:surgery*