• Marcin Czerwinski, Stephanie Ma, and H Bruce Williams.
• The Craniofacial Center, Dallas, TX, USA. marcin.czerwinski@mail.mcgill.ca
• J. Oral Maxillofac. Surg. 2008 Nov 1;66(11):2322-9.

PurposeTrauma to the zygomatic arch classically leads to 1 of 3 injury patterns: fracture with medial displacement, fracture with posterior telescoping, or explosive burst with lateral displacement. We identified an additional injury pattern whereby the arch undergoes significant bending in the axial plane without fracture.Patients And MethodsIn the anatomical part of the study, computed tomography (CT) scans of patients with arch deformation without fracture were analyzed for location, degree, and type of arch bending. In the clinical part, patients were divided into "arch deformation without fracture" and "arch fracture" groups and their demographic characteristics compared. Three patients from each group, all treated with the Gillies' technique, underwent postoperative CT scanning to compare accuracy of zygoma repair.ResultsBending occurred most commonly in the middle and posterior thirds of the zygomatic arch, with average deformation of 11 degrees . Post-Gillies' repair, average residual arch deformation was 2 degrees . Patients with arch deformation without fracture were significantly younger than those with arch fracture (24 yrs vs 42 yrs, P < .05). Unlike patients with arch fractures, all those with arch bending treated with the Gillies' maneuver had near anatomic zygoma realignment.ConclusionZygomatic arch deformation without fracture occurs in 19% of zygoma injuries in our group and is likely elastic in nature. We believe this injury pattern is important clinically as it may decrease the need for coronal exposure, facilitate anatomic repair, and provide stability without hardware fixation.

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