The Effective Reduction Method of Unstable Zygomatic Arch Fracture with Thermo-Splint.

Kim, Soon Heum; Lee, Soo Hyang; Choi, Hyun Gon; Shin, Dong Hyeok; Uhm, Ki Il; Song, Woo Chul

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(1):109-114.
Published online January 1, 2008.

The Effective Reduction Method of Unstable Zygomatic Arch Fracture with Thermo-Splint.

Soon Heum Kim, Soo Hyang Lee, Hyun Gon Choi, Dong Hyeok Shin, Ki Il Uhm, Woo Chul Song

¹Department of Plastic and Reconstructive Surgery,Konkuk University College of Medicine, Chungju and Seoul Hospital, Chungju and Seoul, Korea. plastic7@kku.ac.kr
²Department of Anatomy, Konkuk University College of Medicine, Chungju and Seoul Hospital, Chungju and Seoul, Korea.

Abstract

PURPOSE
The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. METHODS: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo- splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively.
RESULTS
In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint.
CONCLUSION
The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.

Keywords: Unstable zygomatic arch fracture; Protection method; Thermo-splint

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