C-arm Guided reduction of depressed zygomatic arch fractures with internal splinting via Gillies approach | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 23 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2025.412779.1448 | ||
| Author | ||
| safwat adel hegazy* | ||
| plastic surgery department, faculty of medicine, kafr elsheikh university, egypt | ||
| Abstract | ||
| Background: Zygomatic arch fractures have many management options. However, closed reduction with the Gillies approach is the preferred option. Some patients require additional support for the fractured bones after reduction like the insertion of a Foley catheter balloon. Herein, we express our experience with that approach after we had implemented some modifications to make intraoperative steps easier and to enhance patient outcomes. patients and methods: The data of 22 consecutive patients were retrospectively collected. We implemented four modifications to the original technique; (1) the use of the Cobb elevator instead of the conventional periosteal elevator, (2) the use of a silicon catheter rather than the Foleys one, (3) the use of K-wire for introduction of the catheter into the desired space, and (4) the injection of contrast dye instead of saline. Results: The fractures were caused by road traffic accidents in half of the cases. The duration between the injury and the surgical intervention was 6.72 days (range, 2 – 12). The operative time ranged between 20 and 45 minutes, and the catheter was removed after an average of 12.86 days. The operation yielded excellent postoperative outcomes as the median value of both radiological and photographic scores was three. The majority of our patients had excellent satisfaction. Only one patient developed malar asymmetry during postoperative assessment. A balloon leak occurred in one patient with no subsequent disfigurement sequelae. Conclusion: The Gillies approach combined with balloon insertion for fracture stabilization is a safe option for zygomatic arch fractures. Not only is it associated with a low postoperative complication rate, but it also yields excellent cosmetic and satisfaction outcomes. | ||
| Keywords | ||
| Balloon; Gillies approach; Modifications; Zygomatic arch fractures | ||
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