From the Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Brooklyn, NY (Dr Turk); and the Division of Facial Plastic and Craniomaxillofacial Surgery, Department of Otolaryngology, University Hospital of Bern, Bern, Switzerland (Drs Ladrach and Raveh).
The zygomaticomalar complex fracture, also known as the trimalar, tripod, or tetrapod fracture, is a fracture commonly encountered by facial plastic surgeons. Failure to correctly reduce these fractures can lead to facial asymmetry, trismus, diplopia, enophthalmos, and parasthesias. Approaches to the zygomaticomalar complex have been well documented in the literature and include the transconjunctival lateral canthotomy, subciliary blepharoplasty, brow, gingivobuccal, and coronal incisions, or some combination thereof. Fracture fixation is accomplished by the internal placement of miniplates and microplates across properly reduced fracture lines to resist torsional rotation and masticatory distraction. The method of fracture reduction and fixation employed at the University Hospital of Bern, Switzerland,1 shares much with previously published and accepted methods of medial and lateral buttress reconstruction,2 but it introduces several original concepts in an attempt to maximize functional and aesthetic outcomes.
Turk JB, Ladrach K, Raveh J. Repair of Zygomaticomalar Complex FracturesThe Swiss Method. Arch Facial Plast Surg. 1999;1(2):123-126. doi:10.1001/archfaci.1.2.123