Percutaneous Minimal Access Approach for Open Reduction and Internal Fixation of Zygomatic Arch in Zygomatic Complex Fractures: A Simple and Effective Technique

Abstract

Fixation of the zygomatic arch (ZA) in zygomatic complex fractures is often avoided because traditional approaches are extensive and pose a risk to the facial nerve. The percutaneous minimal-access approach for open reduction and internal fixation of ZA offers a simple, effective alternative, while ensuring stable fixation. Unlike conventional hemicoronal or preauricular techniques, it avoids large incisions, reduces scarring, and preserves the facial nerve. Key advantages include shorter operative time, reduced hospital stay, improved cosmetic outcomes, and minimal additional equipment, making it cost-effective. Although potential nerve injury remains a concern, our experience with this approach revealed no such complications. This minimally invasive technique enhances patient safety, quality of care, and postoperative recovery, while also simplifying training and potentially influencing future surgical guidelines in indicated cases. Challenges include limited access to the posterior portion of ZA fractures. Comparative studies with a larger sample size are needed for broader validation.