Case presentation
A 23 year old male patient reported to the department of oral and maxillofacial surgery with a chief complaint of swelling and pain in left side of face. The patient gave a history of fall from height causing trauma to face 8 days back at the time of presentation. On examination, a depression was found on the left pre-auricular region (Fig:1,2). Palpation over the same area revealed step deformity and tenderness. Patient had restricted mouth opening, however the occlusion was satisfactory. The patient was subjected to routine investigations and radiographs like submentovertex view and CT scan. Both the submentovertex (Fig:3)and CT scan (Fig:4,5) reveals left side zygomatic fracture with depressed arch. A diagnosis of left sided isolated zygomatic arch fracture was made based on the clinical examination and radiographs.
The case was posted for surgery under general anaesthesia. Pre operatively USG was used to identify the zygomatic arch fracture. Marking was done (Fig:6). Pre op USG shows discontinuation of left side of zygomatic arch due to fracture (Fig:7). Reduction of the zygomatic arch fracture was done by Gille’s temporal approach using Rowe’s zygomatic elevator. Post reduction USG was done to evaluate the fracture site which shows the reduced arch (Fig:8). Post-operative recovery was uneventful with good mouth opening and with no cosmetic deficit.