Kirschner wire as a guide to secondary reconstruction of the deformities of the zygoma. A technical note

Mistreated fractures of the zygomatic complex may result in facial enlargement, loss of zygomatic projection, increase of orbitary volume, diplopy, enophthalmy, neuropraxy of the infraorbitary nerve and limited mouth opening. Hence, the treatment of sequelae demands accurate planning, through approaches that evaluate the degree of the existing displacement, bone repositioning and the need of grafts. Surgery is difficult due to lack of anatomical references as guides for bone repositioning. Some techniques have been described in the literature as alternatives for evaluating the degree of bone displacement and necessary correction. We believe that a greater number of anatomical references may contribute to a better final result. The aim of this paper is to present a simple technique using three Kirschner wires as spacial parameters-guides that aid secondary reconstructions of fractures of the zygomatic complex. After osteotomy, it becomes possible to compare and transfer the measures of the non-affected bone for re-establishing an adequate anatomical position for the affected side. This approach is proposed as a useful tool for obtaining 3-D references, helping to obtain a better bone positioning.