Keen’s approach is a closed reduction technique for isolated zygomatic arch fractures, performed via an intraoral incision in the maxillary buccal vestibule (upper gingival sulcus), allowing indirect elevation with a Rowe's disimpaction forceps or similar instrument inserted through the incision to access and lift the depressed arch. This method minimizes visible scarring, avoids facial nerve risk, and prevents external incisions, though it requires careful closure to avoid complications like oroantral fistula. It contrasts with extraoral approaches (e.g., Gillies temporal), percutaneous stab incisions (e.g., for screws), or transbuccal punctures.
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