Three-dimensional intraoperative computed tomography imaging for zygomatic fracture repair

Oren Peleg*, Clariel Ianculovici, Amir Shuster, Eitan Mijiritsky, Itay Oz, Shlomi Kleinman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods: This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results: The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion: Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

Original languageEnglish
Pages (from-to)382-387
Number of pages6
JournalJournal of the Korean Association of Oral and Maxillofacial Surgeons
Issue number5
StatePublished - 31 Oct 2021


  • CT X ray
  • Maxillofacial injury
  • Maxillofacial procedure
  • X-ray computed tomography
  • Zygomatic fractures


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