![]() For this reason we discourage the use of this technique by surgeons with little experience. Unless a surgeon has access to intraoperative imaging, it is nearly impossible to determine that a correct anatomical reduction has been achieved using the closed technique. ![]() Pre- and postoperative ophthalmologic examinations should be considered in all patients who have sustained periorbital trauma. A forced duction test should be performed following the reduction of the zygoma to make sure that the patient does not have entrapment of the soft tissues. It is possible that the periorbital contents may have been affected by the reduction of the zygomatic-complex fracture. Proper reduction of the zygoma addresses the issues of the AP projection of the width of the midface. One goal is to restore the proper orbital volume and to restore the proper width, AP projection, and height of the midface. In order to achieve proper reduction of the lateral orbital wall, the greater wing of the sphenoid and the zygoma must be properly aligned. A surgeon may choose to omit fixation under those special circumstances.Ĭorrect anatomical reduction is required to reproduce the original structure of the zygomaticomaxillary complex and the proper alignment of the orbital walls. CPT 21365 in section: Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod. In rare situations a surgeon may have a simple noncomminuted zygomatic-complex fracture which, with closed manipulation, snaps into a perfect reduction and then appears to be very stable. ![]() This technique is contraindicated if there is a fracture displacement at the zygomaticofrontal suture. Closed treatment of fractures of the zygomatic complex refers to the management of fractures of the zygomatic complex where, either prior to or following the reduction of the zygoma, the patient does not have a significant orbital defect. ![]()
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