The Use of O-Arm Imaging to Guide Zygomaticomaxillary Complex Fracture Reduction.

Zygomaticomaxillary complex (ZMC) fractures are among the most common midfacial injuries. Achieving precise 3-dimensional reduction in these areas remains challenging due to complex anatomy and limited intraoperative visualization. Intraoperative imaging modalities such as computed tomography (CT) and cone-beam CT (CBCT) have been shown to improve reduction accuracy and reduce revision rates, but the utility of the O-arm, a mobile intraoperative CT platform, has not been well studied. The authors present the case of a 17-year-old male presenting with a tetrapod fracture after physical assault and demonstrate how intraoperative O-arm imaging can be used to provide effective feedback that directly informs surgical management.