European Journal of Plastic Surgery

, Volume 19, Issue 6, pp 300–306 | Cite as

The Gillies procedure in the treatment of zygomatic fractures and dislocations

  • F. B. Niessen
  • D. B. van Egmond
  • T. F.J.M. Specken
  • M. P. Carpentier Alting


This retrospective study demonstrates the late results of 46 patients with an isolated zygomatic fracture and/or dislocation, who have been treated with the Gillies procedure alone or with stabilizing transosseous wires. The post-reduction stable fractures (78%) treated solely with the Gillies procedure have given satisfactory symmetric results in 72% of the patients. The stabilized zygomatic complexes (22%) could, due to the pull of the m. masseter, still rotate around the axis of stabilization and this causes asymmetry in 60% of the cases. Unstable fractures and dislocations, however, need an open reduction and an adequate stabilization with miniplates at the frontozygomatic suture and infraorbital rim. The amount of dislocation on X-ray will not predict the peroperative instability and the late asymmetry of the treated zygoma fracture.

Key words

Zygoma fracture Gillies procedure Miniplates 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adams WM, Adams LH (1956) Internal wire fixation of facial fractures. Am J Surg 92:12–17Google Scholar
  2. 2.
    Ardekian L, Kaffe I (1993) Comparative evaluation of different radiographic projections of zygomatic complex fractures. J Craniomaxillofac Surg 21:120–123Google Scholar
  3. 3.
    Bähr W, Bagambisa FB (1992) Comparison of transcutaneous incisions used for exposure of the infraorbital rim and orbital floor: a retrospective study. Plast Reconstr Surg 90:585–591Google Scholar
  4. 4.
    Balle V, Christensen PH (1982) Treatment of zygomatic fractures: a follow-up study of 105 patients. Clin Otolaryngol 7:411–416Google Scholar
  5. 5.
    Beck RA, Blakeslee DB (1989) The changing picture of facial fractures. Arch Otolaryngol Head Neck Surg 115:826–829Google Scholar
  6. 6.
    Bosniak SL, Tizes BR (1987) Trimalar fractures: diagnosis and treatment. Adv Ophthalmoc Plast Reconstr Surg 6:403–414Google Scholar
  7. 7.
    Champy M, Lodde JP (1986) Attempt at systematization in the treatment of isolated fractures of the zygomatic bone: techniques and results. J Otolaryngol 15:39–43Google Scholar
  8. 8.
    Chuong R, Kaban LB (1986) Fractures of the zygomatic complex. J Oral Maxillofac Surg 44:283–288Google Scholar
  9. 9.
    Davidson J, Nickerson D (1990) Zygomatic fractures: comparison of methods of internal fixation. Plast Reconstr Surg 86: 25–32Google Scholar
  10. 10.
    Desloovere C, Meyer-Breiting E (1988) Miniplattenosteosynthese bei Jochbeinfrakturen. Ergänzung oder Alternative? Laryngol Rhinol Otol 67:634–638Google Scholar
  11. 11.
    Dingman RO, Natvig P (1976) Surgery of facial fractures. Saunders, Philadelphia, pp 218–220Google Scholar
  12. 12.
    Ehrenfld M, Mast G (1991) Reposition nach Strohmeyer/Waßmund versus Elevation nach Gillies. Fortschr Kiefer Gesichtschir 36:96–99Google Scholar
  13. 13.
    Eisele DW Duckert LG (1987) Single-point stabilisation of zygomatic fractures with the minicompression plate. Arch Otolaryngol Head Neck Surg 113:267–270Google Scholar
  14. 14.
    Ellis E, El-Attar A (1985) An analysis of 2.067 cases of zygomatico-orbital fracture. J Oral Maxillofac Surg 8:417–4218Google Scholar
  15. 15.
    Ewers R, Härle F (1985) Experimental and clinical results of new advances in the treatment of facial trauma. Plast Reconstr Surg 75:25–31Google Scholar
  16. 16.
    Finlay PM, Ward-Booth RP (1984) Morbidity associated with the use of antral packs and external pins in the treatment of the unstable fracture of the zygomatic complex. Br J Oral Maxillofac Surg 22:18–23Google Scholar
  17. 17.
    Freihofer HPM, Borstlap WA (1989) Reconstruction of the zygomatic area. J Craniomaxillofac Surg 17:243–248Google Scholar
  18. 18.
    Gillies HD, Kilner JP (1927) Fractures of the malar-zygomatic compound: with a description of a new X-ray position. Br J Surg 14:651–659Google Scholar
  19. 19.
    Haase S, Hauk S (1991) Zur Behandlung von Jochbeinfrakturen. Dtsch Zahn-Mund-Kieferheilkd 79:657–662Google Scholar
  20. 20.
    Holmes KD, Matthews BL (1989) Three-point alignment of zygoma fractures with miniplate fixation. Arch Otolaryngol Head Neck Surg 115:961–963Google Scholar
  21. 21.
    Hohmann B, Wray RC (1981) A randomized comparison of four incisions for orbital fractures. Plast Reconstr Surg 67:732–735Google Scholar
  22. 22.
    Hylander WL, Johnson KR (1992) Muscle force recruitment and biomechanical modeling: An analysis of masseter muscle function during mastication in Macaca fascicularis. Am J Physiol Anthropol 88:365–387Google Scholar
  23. 23.
    Jackson IT (1989) Classification and treatment of orbitozygomatic and orbitoethmoid fractures. Clin Plast Surg 16:77–91Google Scholar
  24. 24.
    Karlan MS, Cassisi NJ (1979) Fractures of the zygoma. Arch Otolaryngol 105:320–327Google Scholar
  25. 25.
    Knight JS, North JF (1961) The classification of malar fractures: an analysis of displacement as a guide to treatment. Br J Plast Surg 13:325–330Google Scholar
  26. 26.
    Kristensen S, Tveterås (1986) Zygomatic fractures: classification and complications. Clin Otolaryngol 11:123–129Google Scholar
  27. 27.
    Larsen OD, Thomsen M (1978) Zygomatic fractures. Scand J Plast Reconstr Surg 12:55–63Google Scholar
  28. 28.
    Lund K (1971) Fractures of the zygoma: a follow-up on 62 patients. J Oral Surg 29:557Google Scholar
  29. 29.
    Lundin K, Ridell A (1973) One thousand maxillo-facial and related fractures at the ENT-Clinic in Gothenburg. A two-year prospective study. Acta Otolaryngol 75:359–363Google Scholar
  30. 30.
    Manson PN, Grivas A (1976) Studies on enophthalmus: 2. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg 77:203–214Google Scholar
  31. 31.
    Manson PN, Crawley WA (1985) Midface fractures: Advantages of immediate extended open reduction and bone grafting. Plast Reconstr Surg 76:1–12PubMedGoogle Scholar
  32. 32.
    Nordgaard JO (1976) Persistent sensory disturbances and diplopia following fractures of the zygoma Arch Otolaryngol 102:80–82Google Scholar
  33. 33.
    Ogden GR (1991) The Gillies method for fractured zygomas. J Oral Maxillofac Surg 49:23–25Google Scholar
  34. 34.
    Pearl RM (1990) Prevention of enophthalmus: a hypothesis. Ann Plast Surg 25:132–133Google Scholar
  35. 35.
    Pozatek ZW, Karan LB (1973) Fractures of the zygomatic complex: an evaluation of surgical management with special emphasis on the eyebrow approach. J Oral Surg 31:141–148Google Scholar
  36. 36.
    Rinehart GC, Mash JL (1989) Internal fixation of malar fractures: an experimental biophysical study. Plast Reconstr Surg 84:21–28Google Scholar
  37. 37.
    Rootman J (1988) Diseases of the orbit. Lippincott, Philadelphia, pp 83–85Google Scholar
  38. 38.
    Rowe NL, Killey HC (1968) Fractures of the facial skeleton. Williams and Wilkins, Baltimore, pp 276–344Google Scholar
  39. 39.
    Rowe NL, Williams JL (1986) Maxillo-facial injuries. Churchill Livingstone, New York, pp 473–491Google Scholar
  40. 40.
    Scherer M, Sullivan WG (1989) An analysis of 1.423 facial fractures in 788 patients at an urban trauma center. J Trauma 29:388–390Google Scholar
  41. 41.
    Schindelhauer P (1990) Zur Therapie der Jochbeinfraktur. Zahn Mund Kieferheilkd 78:615–619Google Scholar
  42. 42.
    Schroeder HG, Albanese SI (1990) Fractures of the zygoma. Fac Plast Surg 167–175Google Scholar
  43. 43.
    Wavak P, Zook EG (1979) Immobilization of fractures of the zygomatic bone with an antral pack. Surg Gynaecol Obstet 149:587–589Google Scholar
  44. 44.
    Winstanley RP (1981) The management of fractures of the zygoma. Int J Oral Surg 10 [Suppl 1]:235–240Google Scholar
  45. 45.
    Yanagisawa E (1973) Pitfalls in the management of zygomatic fractures. Laryngoscope 83:527–546Google Scholar
  46. 46.
    Zingg M, Chowdhury K (1991) Treatment of 813 zygoma-lateral orbital complex fractures. Arch Otolaryngol Head Neck Surg 117:611–622Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • F. B. Niessen
    • 1
  • D. B. van Egmond
    • 1
  • T. F.J.M. Specken
    • 1
  • M. P. Carpentier Alting
    • 1
  1. 1.Department of Plastic SurgerySt. Antonius HospitalNieuwegeinThe Netherlands

Personalised recommendations