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KMID : 0358819910180010107
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1991 Volume.18 No. 1 p.107 ~ p.113
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OPEN REDUCTION OF THE TRIPOD MALAR FRACTURE AND THE MASSETER MYOTOMY AT THE ORIGIN
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Kim Jong-Ryoul
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Abstract
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Open reduction with internal fixation of the displaced zygoma fractures is necessary to avoid facial asymmetry, ocular dysfunction, and masticatory impairment.
Generally the tripod malar fractures have been treated with two-point fixation. But secondary malposition can develop as a result of masseter pull. Masticatory forces can both rotate and displace zygoma. So the two-point rim fixation may be indadequate to stabilize the tripod malar fracture against the tonic downward pull of the masseter muscle, especially if the thin lateral wall of the maxillary antrum has been damaged.
Authors attempted to treat the tripod malar fractures with the simultaneous use of the three-point or four-point fixation and the masseter muscle myotomy at the origin. Postsurgical depression did not recur in follow-up, which was commom in the standard Open Reduction and internal fixation procedures.
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