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