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Placement of screws is highly variable

The order of placement of screws in the fracture segments is highly variable depending on the degree of comminution of the zygomatic arch. One consideration can be to begin with a screw nearest the fracture, on the stable portion of the zygoma, with the second screw being placed nearest the fracture on the stable portion of the temporal bone, making sure that the entire span of the plate is not canted above or below the zygomatic arch. The order of the additional screws can be according to the convenience of the surgeon and the fracture pattern.