CPT® Code 21366

Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)

The procedure described by CPT® Code 21366 involves the open treatment of complicated fractures in the malar area, which includes the zygomatic arch and malar tripod. These types of fractures are characterized as complicated due to their nature, which may include comminuted fractures or those that affect cranial nerve foramina. In this surgical intervention, the physician employs an open approach to access the fracture site, allowing for direct visualization and manipulation of the fractured bones. The use of multiple surgical techniques, such as a transoral incision through the maxillary buccal vestibule, facilitates access to the affected area. Once the fracture is accessed, the physician carefully reduces the fracture to its correct anatomical position, often utilizing specialized instruments like the Carroll-Girard screw to lift and align the fractured segments. Additionally, the procedure includes obtaining a bone graft from the patient’s own body, which may be harvested from areas such as the hip, rib, or skull. This graft is then placed into the defect areas to promote healing and stability. To ensure proper alignment and support of the fractured bones, the physician employs screws, wires, and/or plates for stabilization. Finally, all incisions made during the procedure are meticulously closed to promote optimal healing and recovery.