First percutaneous reduction and next external suspension with Steinmann pin and Kirschner wire of isolated zygomatic fractures

Abstract

We have introduced a less invasive, simple, and effective method for zygomatic fractures using percutaneous reduction with a Steinmann pin (S-pin) and temporary external suspension with a Kirschner wire (K-wire).For 2 years, 51 patients underwent first percutaneous reductions and then fixations, which is a method that we developed. After the S-pin no. 1 was percutaneously inserted at the most prominent point of the zygoma, closed reduction was first attempted using lever movement and temporary external suspension with a K-wire. If required, 1-site rigid fixation was performed on the zygomaticomaxillary buttresses via gingivobuccal incisions. Only 13 patients received K-wire suspensions and 38 patients received K-wire suspensions and lateral buttress fixations. We evaluated the postoperative result in 4 aspects (flattening, symmetry, scar, and paresthesia) using the 4-point visual analog score after at least 6 months.The mean maintenance period of the S-pin and K-wire was 12.3 days, and the mean operation time was 33 minutes. No serious complications, such as infections or external wire instability, were observed. Excellent or good results were achieved in more than 95% of patients in all 4 aspects mentioned.We believe that our method, which is the first percutaneous reduction using S-pin and temporary external suspensions with a K-wire with or without a lateral buttress rigid fixation, is a simple and effective method for noncomminuted zygomatic fractures