Simple Fixation Technique Using Double Kirschner's Wires for the Uncomminuted Zygoma Fracture

Zygoma fracture is very common in facial trauma because zygoma composes a prominent part of the midface. For the zygoma fracture, its precise reduction and fixation is very important to prevent residual facial asymmetry. There are various modalities of treatment of fractured zygoma and now open reduction with multiple rigid fixation technique is widely accepted. The method of internal fixation enables accurate reduction and stable fixation. However, closed reduction can be used in simple and uncomminuted cases. Although the closed reduction has some advantages of simplicity, it has lost popularity because of the inadequate mechanical fixation and poor visualization. We designed an improved technique of the closed reduction and fixation using double Kirschner's wires. 19 patients were treated with this technique and all cases showed successful results without any complications. The potential advantages of this technique include simple procedure, short operation time, less incisional scar and soft tissue violation and fairly low price without use of foreign materials like miniplates. We conclude that double Kirschner's wire suspension technique is a simple and effective method in the treatment of uncomminuted zygoma fracture.

Topical Hyperbaric Oxygen Therapy on Composite Graft & Local Flap on Facial Area

Composite graft and local flaps are good modality for the correction of deformatic scars in facial area but there are several limitations in size, shape and graft bed condition. Hyperbaric oxygen therapy is a good adjunctive therapy for the successful take of the composite graft and local flaps by providing high arterial oxygen pressure and hyperoxic state promoting angiogenesis and collagen synthesis. However, it has some substantial risks of systemic oxygen toxicity to central nervous system, lung and eyes, and needs hyperbaric chamber system and high cost. We designed a modified technique for administrating hyperbaric oxygen topically with the use of simple materials and wall oxygen for the composite graft and local flap wound. 8 patients who had undergone composite graft and local flap on facial scar area were treated with topical hyperbaric therapy for average 6 days. Grafts were relatively large in size and all of the graft bed was scar tissue due to previous operation, trauma and burn injury. All cases showed successful result and there was no complication reported. The potential advantage of this method includes fairly low expense, no need for specialized equipment, simplicity of the application and lack of systemic complication. We conclude that topical hyperbaric oxygen therapy was a simple, cost-effective and safe method for the adjunctive treatment to the composite graft and local flaps.