C-arm as intraoperative control in reduction of isolated zygomatic arch fractures: a randomized clinical trial

Purpose Isolated zygomatic arch fractures (IZAFs) are habitually reduced at a distance, via a temporal approach. Open reductions are not recommended due to the associated morbidity and complications. However, performing closed reductions makes it difficult to determine whether it was done satisfacto...

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Bibliographic Details
Published in:Oral and maxillofacial surgery 2016-03, Vol.20 (1), p.79-83
Main Authors: Pedemonte, Christian, Sáez, Felipe, Vargas, Ilich, González, Edgardo, Canales, Marco, Lazo, Diego, Pérez, Hernán
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Algorithms
Cone-Beam Computed Tomography - instrumentation
Dentistry
Female
Fracture Fixation - methods
Humans
Image Processing, Computer-Assisted - instrumentation
Male
Medicine
Medicine & Public Health
Middle Aged
Oral and Maxillofacial Surgery
Original Article
Postoperative Complications - diagnostic imaging
Radiographic Image Enhancement - instrumentation
Surgery, Computer-Assisted - instrumentation
Young Adult
Zygomatic Fractures - diagnostic imaging
Zygomatic Fractures - surgery
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Summary:Purpose Isolated zygomatic arch fractures (IZAFs) are habitually reduced at a distance, via a temporal approach. Open reductions are not recommended due to the associated morbidity and complications. However, performing closed reductions makes it difficult to determine whether it was done satisfactorily. This study aims to determine whether the acquisition of intraoperative images with a C-arm to evaluate IZAF reductions is a useful technique in treating such fractures. Methods Our hypothesis is that acquiring intraoperative images with a C-arm reduces the need for a second surgery. Between 2009 and 2012, 50 patients who were diagnosed with IZAF requiring surgery were randomly distributed into two groups: 25 patients were in the experimental group, where fracture reduction was performed and immediately corroborated intraoperatively for an adequate result using a C-arm, and 25 patients were assigned to a control group where the fracture reduction was controlled with post-surgery imaging. Results The results did not reveal significant differences between both groups ( p  = 0.5). Nevertheless, the experimental group had the advantage of being able to immediately reduce the fracture again if the result was unsatisfactory. Conclusions Despite the fact that the results are not statistically significant ( p  = 0.5), the authors recommend undertaking an intraoperative imaging analysis in areas where we are not certain of the reduction.
ISSN:1865-1550
1865-1569
DOI:10.1007/s10006-015-0531-4