Use of high-frequency ultrasound guidance for intraoperative zygomatic arch fracture reduction.

Zygomatic arch fractures are common facial fractures; the management depends on the extent of the injury, the displacement of the bone, and coronoid impingement. For fractures without a need for fixation, an intraoral approach, known as Keen, or a temporal hairline approach, known as Gillies, can be used. However, without direct visualization of the fracture line, there is a risk for inadequate reduction. We have therefore begun to use ultrasound assistance to confirm proper reduction. We believe that intraoperative ultrasound guidance can be used to guide the surgeon toward the most precise fracture reduction and present 3 examples from our practice. We recommend the use of ultrasound in the reduction of zygomatic arch fractures.