The use of the image intensifier in fractures of the zygomatic arch--a technical note

Intra-operatively satisfactory reduction of a depressed zygomatic arch fracture is usually assessed by two means. The external aspect of the zygomatic arch may be palpated and compared to the uninjured opposite side. Secondly an instrument may be rolled under the arch to identify bony steps or discontinuities. Both of these methods are subjective. Occasionally fracture reduction is inadequate or unstable and if this not discovered until the post-operative assessment re-operation may be necessary. We have used the C-arm image intensifier intra-operatively to objectively assess the adequacy of fracture reduction. The equipment required is widely available and the technique is easily performed. Hardcopies can be produced and saved in the health care record thus obviating the need for post-operative imaging.