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Anatomic Basis of Percutaneous Kirschner Wire Insertion in Zygoma Fractures

Cömert, Ela MD*†; Cömert, Ayhan MD; Uz, Aysun MD; Tuncel, Ümit MD*; Elhan, Alaittin MD

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1483-1485
doi: 10.1097/SCS.0b013e31821d1927
Anatomical Studies

The combination of Gillies elevation with 1-point percutaneous Kirschner wire fixation of isolated simple zygoma fractures was found to be effective in restoring preinjury appearance and function and avoiding soft tissue morbidity. The proximity of the infraorbital nerve, inferior orbital rim, and dental roots warrants care in the placement of the wire. The need for precise anatomic guidelines becomes apparent when considering these relationships. Eighteen adult skulls (36 sides) were examined, and specific points were determined that could be important while inserting Kirschner wire for zygoma fractures, and the distances between those points were measured with a digital caliper. Then, by using these points, the wire was inserted into the zygoma through the medial wall of the maxillary sinus, and the insertion point of the wire on the lateral wall of the maxilla and the angle of the wire were determined. The mean lengths of the wires of the right and left sides of each skull were counted, and for 18 skulls, the mean length of the wire was measured as 45.12 mm. Direction of the insertion during drilling zygoma, conversely to the location of the insertion, nearly determines the course of the wire and the point of insertion on the lateral wall of the maxilla. Obtaining precise information concerning the installation angle and length of the wire before surgery should contribute to safer and smoother surgical procedures.

From the *Clinic of Otolaryngology Head and Neck Surgery, Ankara Oncology Education and Research Hospital; and †Department of Anatomy, Faculty of Medicine, Ankara University, Ankara, Turkey.

Received August 22, 2010.

Accepted for publication September 4, 2010.

Address correspondence and reprint requests to Ela Cömert, MD, Department of Anatomy, Faculty of Medicine, Ankara University, Morfoloji Binası, Anatomi Anabilim Dalı, 2. kat, 06100, Sihhiye, Ankara, Turkey; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD