This is suitable for fractures that are nondisplaced or minimally displaced or where systemic status precludes operative intervention. Stable, nondisplaced fractures may be observed weekly for healing. Avoidance of nose blowing is mandatory in the medical care of these patients. The disrupted orbital walls can allow air to be forced into the retrobulbar space and cause pain and visual loss. The routine use of systemic antibiotics for isolated zygomatic arch fractures generally is not recommended.
Most surgeons advise surgical intervention prior to the formation of dense scar tissue.
Traditionally, closed-reduction techniques were the method of choice for nearly all zygomatic fractures. Although open techniques currently are favored, closed-reduction techniques may be suitable for isolated arch fractures and minimally displaced noncomminuted fractures. This approach provides direct access to the frontozygomatic suture, orbital floor, and infraorbital rims. The inferior orbital rim and floor can be exposed via an infraciliary or transconjunctival approach. The transconjunctival incision gives excellent exposure and saves the patient a visible scar on the face.