Intraoperative ultrasonographic evaluation of inferior orbital rim reduction in non-comminuted zygomatic fractures: A case series of six patients

Zygomatic fractures are common in maxillofacial trauma and often require surgical intervention for the restoration of facial symmetry. The inferior orbital rim significantly influences cheekbone asymmetry. The management of zygomatic fractures involves estimating the adequacy of reduction by comparing the malar projection on the fracture and healthy sides. This clinical approach is subjective and lacks precision. Six consecutive patients with non-comminuted zygomatic fractures were included in the study. Ultrasound was performed pre- and post-reduction during the surgery to visualize the fracture site and measure the displacement by visualizing the periosteal discontinuity. The results were compared with those of pre- and post-operative CBCT scans. Ultrasound demonstrated comparable efficacy to CBCT for assessing fracture reduction. Unlike CBCT, ultrasound involves no radiation exposure and allows for real-time intra-operative assessment, potentially reducing the need for revision surgery. Ultrasound is a precise and practical modality for evaluating zygomatic fracture reduction during J-hook procedures. It offers a radiation-free, inexpensive and readily available modality that improves intra-operative decision-making.