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The use of the foley balloon catheter in zygomatic-arch fractures
British Journal
of Oral Surgery
(1974), 12, 246-248
THE USE OF THE FOLEY BALLOON CATHETER ZYGOMATIC-ARCH FRACTURES L. PODOSHIN E.N.T.
IN
and M. FRADIS
Department, Rothschild University Hospital, AbaKhoushy Medicine, Ha;fa, Israel
School of
Summary. A method for the reduction of fractures of the zygomatic arch by the use of Foley catheter is suggested. This method has been tried on eight cases with good results. It seems to us that the suggested method is a simple one, without complications and superior to the methods used so far. THE increasing number of road accidents, work accidents and violence in these times is reflected in the increasing number of people suffering from trauma to the head and face. The zygomatic bone is a compact bone, firmly attached to the maxilla, but with weak attachments to the frontal bone and temporal bone. Trauma to the side of the face may result in fracture of the fronto-zygomatic suture, the zygomatic arch and the inferior orbital margin. This triple fracture is often called a tripoid Occasionally we may encounter an isolated fracture of the zygomatic fracture. arch only.
FIG. 2
FIG. I Fig. I.-Radiograph Fig. 2-Position
showing comminuted fracture of the left zygomatic arch. of the Foley catheter balloon, under the zygomatic arch.
This paper describes a technique for the reduction of zygomatic-arch fractures, using a Foley balloon catheter. We have used this technique in eight cases, with good results. Received
1.5.74.
Accepted 246
17.7.74
THE
FOLEY
BALLOON
CATHETER
IN
ZYGOMATIC-ARCH
FIG. 3 The
patient with the Foley catheter fixed on the forehead.
FIG. 4 Radiograph showing the balloon filled with contrast material under the fractured area of the zygomatic arch.
1212-R
FRACTURES
247
248
BRITISH
JOURNAL
OF ORAL SURGERY
A TYPICAL
CASE
A male aged 65 years was admitted after a road accident without concussion of the brain. On admission a large swelling of the left cheek was found. The patient complained of difficulty in opening his mouth. A depression was seen in the area of the left zygomatic arch. X-rays of the zygoma (Fig. I) showed a comminuted fracture of the left zygomatic arch. Under general anaesthesia a horizontal incision 2 cm long was made, 3 cm above and parallel with the zygomatic arch. A subcutaneous canal to the area of the fracture was made with a blunt raspatory, and the raspatory was introduced under the fractured bone. A Foley balloon catheter No. 14 was introduced (Fig. 2) and 5 cc contrast material was injected into the balloon. The other side of the catheter was fixed on the forehead with plaster (Fig. 3). Control x-rays showed the position of the catheter and a good reposition of the fracture (Fig. 4). DISCUSSION In the last few years, the use of the Foley balloon catheter in the reduction of various fractures of the facial complex has been described. In 1956 Jackson et al. reported the use of the Shea-Anthony catheter in two cases of zygomatic fractures. Jarabak (1958) and Gutman et al. (1965) used the Foley catheter in reduction of fractures of the maxilla. Podoshin and Altman (1967) used the Foley catheter for the reduction of depressed fractures of the frontal sinus. Maron and Glover (1971) reported the use of the Foley catheter in 20 cases with tripoid fractures. The suggested method of reduction of the fractures of the zygomatic arch seems to us superior to the methods used so far. It seems superior to wiring, Wire sutures are not suitable for small especially in comminuted fractures. fragments of bone and may give rise to delayed reaction, which requires removal of the wire at a later date. In addition when wire is used, one of the complications is a scar on the face, which does not occur by our method. In our opinion this method of reduction of the zygomatic-arch fractures is simple and without complications. Filling the balloon of the Foley catheter with contrast material allows control as to placement of the balloon and position of the fractured parts. REFERENCES GUTMAN, D., LAIJFER,D. & NEDER, A. (1965). British Journal of Oral Surgery, 2, 153. JACKSON,V. R., ABBEY, J. A. & GLANZ, S. (x956). Journal of Oral Surgery, 14, 14. JARABAK,Y. I?. (1958). Journal of Oral Surgery, 17, 39. MARAN,A. G. D. & GLOVER, W. G. (1971). J ournal of Laryngology and Otology, 55,903. PODOSHIN, L. & ALTMAN, M. M. (1967). Journal of Laryngology and Otology, 51, 1157.
of Oral Surgery
(1974), 12, 246-248
THE USE OF THE FOLEY BALLOON CATHETER ZYGOMATIC-ARCH FRACTURES L. PODOSHIN E.N.T.
IN
and M. FRADIS
Department, Rothschild University Hospital, AbaKhoushy Medicine, Ha;fa, Israel
School of
Summary. A method for the reduction of fractures of the zygomatic arch by the use of Foley catheter is suggested. This method has been tried on eight cases with good results. It seems to us that the suggested method is a simple one, without complications and superior to the methods used so far. THE increasing number of road accidents, work accidents and violence in these times is reflected in the increasing number of people suffering from trauma to the head and face. The zygomatic bone is a compact bone, firmly attached to the maxilla, but with weak attachments to the frontal bone and temporal bone. Trauma to the side of the face may result in fracture of the fronto-zygomatic suture, the zygomatic arch and the inferior orbital margin. This triple fracture is often called a tripoid Occasionally we may encounter an isolated fracture of the zygomatic fracture. arch only.
FIG. 2
FIG. I Fig. I.-Radiograph Fig. 2-Position
showing comminuted fracture of the left zygomatic arch. of the Foley catheter balloon, under the zygomatic arch.
This paper describes a technique for the reduction of zygomatic-arch fractures, using a Foley balloon catheter. We have used this technique in eight cases, with good results. Received
1.5.74.
Accepted 246
17.7.74
THE
FOLEY
BALLOON
CATHETER
IN
ZYGOMATIC-ARCH
FIG. 3 The
patient with the Foley catheter fixed on the forehead.
FIG. 4 Radiograph showing the balloon filled with contrast material under the fractured area of the zygomatic arch.
1212-R
FRACTURES
247
248
BRITISH
JOURNAL
OF ORAL SURGERY
A TYPICAL
CASE
A male aged 65 years was admitted after a road accident without concussion of the brain. On admission a large swelling of the left cheek was found. The patient complained of difficulty in opening his mouth. A depression was seen in the area of the left zygomatic arch. X-rays of the zygoma (Fig. I) showed a comminuted fracture of the left zygomatic arch. Under general anaesthesia a horizontal incision 2 cm long was made, 3 cm above and parallel with the zygomatic arch. A subcutaneous canal to the area of the fracture was made with a blunt raspatory, and the raspatory was introduced under the fractured bone. A Foley balloon catheter No. 14 was introduced (Fig. 2) and 5 cc contrast material was injected into the balloon. The other side of the catheter was fixed on the forehead with plaster (Fig. 3). Control x-rays showed the position of the catheter and a good reposition of the fracture (Fig. 4). DISCUSSION In the last few years, the use of the Foley balloon catheter in the reduction of various fractures of the facial complex has been described. In 1956 Jackson et al. reported the use of the Shea-Anthony catheter in two cases of zygomatic fractures. Jarabak (1958) and Gutman et al. (1965) used the Foley catheter in reduction of fractures of the maxilla. Podoshin and Altman (1967) used the Foley catheter for the reduction of depressed fractures of the frontal sinus. Maron and Glover (1971) reported the use of the Foley catheter in 20 cases with tripoid fractures. The suggested method of reduction of the fractures of the zygomatic arch seems to us superior to the methods used so far. It seems superior to wiring, Wire sutures are not suitable for small especially in comminuted fractures. fragments of bone and may give rise to delayed reaction, which requires removal of the wire at a later date. In addition when wire is used, one of the complications is a scar on the face, which does not occur by our method. In our opinion this method of reduction of the zygomatic-arch fractures is simple and without complications. Filling the balloon of the Foley catheter with contrast material allows control as to placement of the balloon and position of the fractured parts. REFERENCES GUTMAN, D., LAIJFER,D. & NEDER, A. (1965). British Journal of Oral Surgery, 2, 153. JACKSON,V. R., ABBEY, J. A. & GLANZ, S. (x956). Journal of Oral Surgery, 14, 14. JARABAK,Y. I?. (1958). Journal of Oral Surgery, 17, 39. MARAN,A. G. D. & GLOVER, W. G. (1971). J ournal of Laryngology and Otology, 55,903. PODOSHIN, L. & ALTMAN, M. M. (1967). Journal of Laryngology and Otology, 51, 1157.