Towel clip reduction of the depressed zygomatic arch fracture.

F c ince the first description of a surgical reduction of a ygoma fracture by Duverney in 1751, many varying ethods of treatment have been described. Both inraoral and extraoral methods have become commonlace. The transoral approach was popularized by Keen n 1909, with later modifications by Goldthwaite and uinn. These techniques offer the advantages of avoidng any skin incision, thereby avoiding any visible scarng. Additionally, they allow for minimal dissection and n excellent vector for reduction; however, they may esult in increased rates of infection by introducing oral ora into the infratemporal fossa. Gilles et al described he temporal fossa approach in 1927, and this became a ery popular method for the treatment of isolated arch ractures around the world. Similarly, Dingman and atvig described the supraorbital approach as an exraoral alternative in 1964. All of these techniques have n common the use of a Rowe zygoma elevator, urethral ound, Kelly hemostat, or similar instrument placed beween the arch and coronoid process to achieve reducion. Others have described several percutaneous methds meant to be less invasive. These include passing ire beneath the arch or using a towel clip to directly rasp the bone fragments and allow for lateral force to e applied. The use of a towel clip passed beneath the rch percutaneously has been described previously in a ase series by Hwang and Lee, but little description of he procedure was offered. Fractures of the zygoma are common maxillofacial njuries second only to nasal fractures. While many of hese are of minimal clinical significance, those that