Evaluation of zygomatic complex fractures based on three. Zygomaticomaxillary complex fracture radiology reference. In these situations, the bone will heal completely and will. Methods for the evaluation and management of patients with zygomatic fractures continue to evolve. Discussion the zygomaticomaxillary complex fracture, also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture. Therefore for cosmetic and functional reasons it is imperative to diagnoseand treat zygomatic fractures adequately. There were 552 86% zygoma frac tures and 90 14% zygomatic arch fractures. Evaluation of treatment of zygomatic bone and zygomatic. Zygoma fractures are easy to miss and displaced fractures require treatment within 10 days.
Surgical methods of zygomaticomaxillary complex fracture. The zygomatic arch, or cheek bone, is formed by the zygomatic process of the temporal bone and the temporal process of the zygomatic bone, the two being united by an. Management of zygomatic fractures pocket dentistry. Fracture zygoma and its management our experience core. Through the incision just below the lower eyelid skin, the subciliary. Symptoms of zygomatic fractures include those produced by hemorrhage and edema. A total of 67 conjunctival and secondary incisions were made on 46 patients for repair of zygomatic fractures.
Zygoma fractures are classified according to knight and north based on the direction of anatomic displacement and the pattern created by the fracture. Reduction of zygomatic arch fracture using a towel clip. The vast majority of zygomatic fractures occur in men in their third decade of life. The researchers consider the previous classification system should be improved. A zygoma fracture is often the result of facial trauma such as violence, falls or. Repair of a displaced zygomatic arch fracture is unlike just about every other facial fracture other than that of the nasal bones. A cut is made around the eyes and inside the mouth to access the fracture. Zygomatic fractures are common facial injuries, representing the most common facial fracture 214 or the second in frequency after nasal fractures. Zygoma or cheek bone fracture of zygoma is not usually present alone. Treatment and complications of orbitozygomatic fractures scielo. Zygoma arch fracture an overview sciencedirect topics. A new classification of zygomatic fracture featuring.
Complex fractures may include the cheekbone and part of the orbit of the eye. For complex zygomatic fractures, the coronal approach allows for extensive degloving of the facial bones. Surgical management of zygomatic complex fractures in a major. The fracture will be realigned and then fixed together using titanium plate and screws. Diagnosis and management of common maxillofacial injuries.
Understanding the classification scheme described by. The zygomatic bone occupies a prominent and important position in the facial skeleton. Zygomatic fracture zygomatic zygomatic arch fracture type. In the roentgenographic analysis of 72 cases of zygomatic fractures encountered in the gracenew haven community hospital during the past 7 years we found that in a high percentage of cases, there was a definite or suggestive sign of fracture of the zygomatic arch, namely, an oval or rec tangular, vertical. Orbitozygomatic fractures represent a type of maxillofacial injury that happens very often due to the.
Md, who was the first in their group to suggest and routinely use the upper eyelid incision for zygomatic complex fracture reduction. Other fracture patterns, include isolated zygomatic arch fractures, or zmc fractures with associated panfacial fractures, such as le fort ii and iii. Definitions zygoma is a very crucial component which maintains facial contour. Zygomaticomaxillary complex fracture deepak k gupta 2. Here the fractured zygoma is part of a wider fracture configuration. The zygomaticomaxillary complex fracture, also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture, has four.
Open treatment of depressed malar fracture, including zygomatic arch and malar tripod lay description code. Zygomatic complex fractures are one of the frequently occurring maxillofacial injuries owing to. The temporal process, which forms zygomatic arch a1frontal process, which forms lateral orbital wall a2maxillary process, which forms. Postoperative radiographs of a complex zygomatic fracture.
Fractures of the zygomatic complex and arch pocket. The incidence of isolated bilateral zygomatic fractures has not been reported secondary to. Fractures can involve any of the four articulations of zygoma which include zygomaticomaxillary complex, zygomatic complex proper, orbitozygomatic complex. Complex fractures with comminution of the zygomatic bone indicates zingg fracture types in which the orbital contents are at risk. This is zygomatic arch fracture reduction using a temporal approach. Zygomatic complex fracture is the second most common fracture of facial region just. Comminuted fracture zygoma open reduction and fixation.
I have a zygomatic arch fracture with no deformities. Please use one of the following formats to cite this article in your essay, paper or report. The diagnosis of such fractures can be made by one or more of the following clinical signs. The fracture will be realigned and then fixed together. This is a tshaped device that has a handle at one end with a sharp screw portion perpendicular to.
The most direct approach in reducing a zygomatic fracture is to insert a carrollgirard screw. It is located in an area where direct surgical access is impossible. Treatment of zygomatic complex fractures using two point. The malar complex refers to the zygoma and maxillary bones and therefore forms part of the orbital floor and lateral orbital wall. These fractures occur most commonly as the result of assaults or motor vehicle collisions. Management of zygomaticomaxillary complex zmc fractures should be based on injury patterns and not on training background. Avoid and manage common complications associated with zygomatic fracture repair. This is most commonly seen after assault, but any blow to the cheek may give rise to a fracture.
What is an orbito zygomatic maxillary fracture repair. The zygomatic complex also helps in transmitting the occlusal forces to the skull base. Zygomatic complex fractures and its management acta scientific. Zygomaticomaxillary complex fracture linkedin slideshare. Image profiled with cmyk may print differently than expected. Reduction of zygomatic fractures using the carrollgirard tbar screw article pdf available in archives of plastic surgery 395. Pdf zygomaticomaxillary complex fracture researchgate. The orbital rim and zygomatic arch are outlined with a marking pen. The maxillary bone was the most common to have an associated fracture figure 6. Zygomaticomaxillary complex fracture wikimili, the free. The zygoma also known as zygomatic bone or malar bone is an important facial bone which forms the prominence of the cheek. These will stay in place unless they cause problems, in which case a second operation will be required to remove them. Zmc complex fracture right zygomaticomaxillary complex fracture with disruption.
Pdf reduction of zygomatic fractures using the carroll. Displaced fractures of the zygomatic bone can result in significant functional and aesthetic sequelae. Moreover the importance of zygomatic complex in facial skeleton lies inprotecting globe of eye and absorbing and redistributing masticatory andexternal load. The zygoma forms a significant portion of the floor and lateral wall of the orbit and. Many zygomatic fractures which have good bony alignment despite the fracture do not require any treatment at all. According to the site of fracture, the patients were divided into three groups. This plays a key role in the structure and function of.
The zygoma forms part of the floor and lateral wall of the orbit and the zygomatic arch is an important feature in the structure and appearance of the face. They are the second most common facial bone fracture after nasal bone fractures pathology. The ages of the patients ranged from 10 to 76 years old, mean age was 32. Principles of internal fixation of the craniomaxillofacial skeletontrauma and. This is a case of a road traffic accident just 24 hours back. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the zygomatic bone.
Note the bone graft arrow this was to make good a continuity defect. Zygomatic fracture zygomatic zygomatic arch fracture type 4 dislocated fracture of zygomatic bone with diastase is available on the lateral orbital rim with dorsokaudaler shear. The authors describe a simple technique for reducing zygomatic arch fractures with a towel clip. A, attempted waters projection showing a vertical radiopaque density in the area of the left zygomatic arch. What is an orbitozygomatic maxillary fracture repair. Please make sure the file is set in the rgb or srgb color profile this is the default profile in most cameras. Fracture lines usually run through the infraorbital rim, involve the posterolateral orbit, and extend to the inferior orbital fissure.