Treatment goals focus on reduction to reestablish normal orbital volume and. Evaluation of onepoint fixation for zygomaticomaxillary complex. Zygoma fractures are easy to miss and displaced fractures require treatment within 10 days. Treating the zygomatic arch fracture depends upon whether it is displace or caved in. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Therefore for cosmetic and functional reasons it is imperative to diagnoseand treat zygomatic fractures adequately. Quad zygoma immediate load an approach for restoring. Low transverse maxillary fracture orbit is not involved fix with maxillomandibular fixation le fort 2. Surgical management of zygomatic complex fractures in a major.
The incidence of isolated bilateral zygomatic fractures has not been reported secondary to rta apart from one such report of a bilateral zygomatic arch fracture. Reduction of fractured zygoma is done by manipulating the broken cheek bone to restore the contour and appearance of the face. Fractures of the cheek bone zygomatic complex this leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions. Patients with simple zygomatic arch fracture, comminuted fracture at each junction of zygoma and other facial bone, and multiple midfacial fractures were excluded in this study. Retrospective clinical and radiographic evaluation of tilted implants used in the treatment of the severely resorbed edentulous maxilla.
Complete dissertation vu research portal vrije universiteit. If you do not have it you can download adobe reader free of charge. Here the fractured zygoma is part of a wider fracture configuration. Treatment of zygomatic complex fractures with surgical or. Click add files and select the files you want to include in your pdf. The zygomatic bone is attached to the maxilla at the zygomaticomaxillary zm suture and alveolus forming the zygomaticomaxillary buttress. Broken zygomatic bone recovery doctor answers, tips. Investigate the risk of earassociated diseases after zygomaticomaxillary complex zmc fracture in a populationbased retrospective cohort study. Pdf surgical methods of zygomaticomaxillary complex fracture. Zygomaticomaxillary complex fracture radiology reference. Fractures of the cheek bone zygomatic complex fractures.
The complication is believed having some connections with the improper selection of surgical method or surgical procedure and deformity or weakening of the zygomatic bone and zygomatic arch. The malar complex refers to the zygoma and maxillary bones and therefore forms part of the orbital floor and lateral orbital wall. For complex zygomatic fractures, the coronal approach allows for extensive degloving of the facial bones. This plays a key role in the structure and function of. Fractures of the zygomatic complex and arch pocket. Facial skeleton detached from skull base floor, medial wall, lateral wall zygoma is involved. I repair zygoma fractures all the time at our local trauma center. Mildly displaced comminuted fracture of the left zygomatic arch shows up to 37 degrees of inwards angulation. Diagnosis and management of common maxillofacial injuries in the emergency department. The atlas of emergency medicine, 4e knoop kj, stack lb.
Treatment modalities in zygomatic complex fractures. The zygoma forms a significant portion of the floor and lateral wall of the orbit and forms a portion of the zygomatic arch, otherwise known as the malar eminence, which plays a key role in the determination of facial morphology. You can merge pdfs or a mix of pdf documents and other files. Fracture du zygoma dr barriere chirurgie maxillofaciale. Complications of zygomatic bone and zygomatic arch plastic. Zygomatic fractures are common facial injuries, representing the most common facial fracture 214 or the second in frequency after nasal fractures. There were 8% 79 type a, 57% 587 type b, and 35% 359 type c fractures in our series. Moreover the importance of zygomatic complex in facial skeleton lies inprotecting globe of eye and absorbing and redistributing masticatory andexternal load.
Zygomatic bone forming the lateral wall of the orbit and giving prominence to the cheek is commonly involved in facial injuries, representing either the most common facial fracture or the second in frequency after nasal fractures. Additionally, the fracture components may result in impingement of the temporalis muscle, trismus difficulty with mastication and may compromise the infraorbital foramennerve. Classification and treatment of zygomatic fractures. The relatively severe complication of the zygoma reduction plastic surgery is the zygomatic bone and zygomatic arch displacement or defect. Definitions zygoma is a very crucial component which maintains facial contour. Surgical anatomy the term tripod fracture attributed to a specific type of zygomatic fracture is a misnomer because, along with its frontal, maxillary, and temporal articulations, the orbital extension of the zygoma has a broad abutment against the greater wing of the sphenoid, thus rendering it a tetrapod. Fractures of the zygomatic arch za or any of its bony articulations can cause. Case report threepoint fixation of displaced tripod.
If you have any other questions that the leaflet does not answer, or if you would like. The zygomatic bone occupies a prominent and important position in the facial skeleton. Another important landmark with respect to zygomatic fractures is the. Zygoma fracture orbit fracture major nasal fracture le fort iii le fort ii. Risk of earassociated diseases after zygomaticomaxillary. The incidence, cause, age, and gender predilection of. Treatment of the zygomatic bone fracture is meant to restore the symmetry of the face, make certain that the eye moves normally in the orbit and address any potential nerve damage. Treatment modalities and surgical methods the purpose in treating zygomatic fractures is to restore the premorbid malar and orbital configuration figure 1. The accuracy of surgical drilling guides was assessed for placement of zygoma implants.
The mechanism of injury usually involves a blow to the side of the face from a fist, from an object, or secondary to motor vehicle accidents. Patient information leaflet fractured zygoma cheekbone this leaflet has been designed to explain your type of fracture and it contains answers to many frequently asked questions. Pdf zygomaticomaxillary complex fracture researchgate. Up to 50% of these fractures will heal with no surgery required. If you have any other questions that the leaflet does not answer or would like further explanation please ask a member of the medical or nursing staff. 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. Zygomatic complex zmc fractures result when disarticulation of the zygomatic bone at the zygomaticofrontal suture along the lateral orbital rim and the zygomaticomaxillary suture medially, as well as along the zygomatic arch to. Head and facial trauma the atlas of emergency medicine. A basilar skull fracture is basically a linear fracture of the skull base. A prospective short clinical study ramesh candamourty 1, vinod narayanan 2, mf baig 2, mr muthusekar 2, manoj kumar jain 3, ramesh m.
N2 the zygomaticomaxillary complex zmc has integral structure and function in the bony skeleton of the face. Anatomical fracture patterns and the nuances of clinical presentations are discussed. To open a pdf file you will need compatible software such as adobe reader. These fractures occur most commonly as the result of assaults or motor vehicle collisions. Zygomatic fractures are common in facial trauma and, as is the case with other facial fractures, occur primarily among men in their third decade of life. Below are the links to the authors original submitted files for images. Head injuries in lateral impact collisions andrew morris, ahamedali hassan, murray mackay and julian hili. Zygomaticomaxillary complex, bone fracture, sphenozygomatic suture, internal. 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.
Zygoma is the second most common site of facial bone fracture. Must distinguish zygomatic arch fracture from zygomaticomaxillary tripod fracture. The prominent convex shape of the zmc makes it particularly vulnerable to injury. Treatment decisionmaking in zygomatic complex fractures.
Trauma resulting in fractures to this area typically does not have localizing symptoms. Fraktur zygomatic pdf definitions zygoma is a very crucial component which maintains facial contour. How to merge pdfs and combine pdf files adobe acrobat dc. Management of zygomatic fractures pocket dentistry. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the zygomatic bone. Ipsilateral eye may appear to tilt due to pulling of lateral canthus. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma. The vast majority of zygomatic fractures occur in men in their third decade of life. This is a retrospective cohort study using taiwans national health insurance research database of. From march 2014 to december 2014, 34 patients with zmc fractures were.
A new classification of zygomatic fracture featuring. Surgical intervention is an effective treatment modality of depressed zygomatic complex fractures, whereas a nonsurgical approach is often. The zygoma may be separated from its 4 atriculations. Differences in soft tissue intermalar height between the fractured.
Surgical treatment of zygomatic bone fracture using two points. Following fractures of the nasal bone, zygomatic fractures are the second most common fractures of the face and predominantly occur in males during their twenties and thirties. The short answer is that your zygoma can be put into a better position without the use of an implant but it is a bit of an ordeal and you will need plates and screws to hold the bones in place. Babu 4 1 department of oral and maxillofacial surgery, indira gandhi institute of dental sciences, mahatma gandhi medical college and research institute campus, pillaiyarkuppam. The zygomatic arch is the third most common fractured facial bone, with a high majority of those cases being male. Injury mechanism and a guide to treatment hisao ogata, yoshiaki sakamoto and kazuo kishi department of plastic and reconstructive surgery, keio university school of medicine, shinjukuward, tokyo, japan. The zygoma is the main buttress between the maxilla and the skull, but, in spite of its sturdiness, its prominent location makes it prone to fracture. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the. These files will have pdf in brackets along with the filesize of the download. Other fracture patterns, include isolated zygomatic arch fractures, or zmc fractures with associated panfacial fractures, such as le fort ii and iii. Pyramidal configuration involve maxillary, nasal, lacrimal, ethmoid, floor lateral wall zygoma not involved le fort 3. Evaluation of treatment of zygomatic bone and zygomatic. Click, drag, and drop to reorder files or press delete to remove any content you dont want. Fractures of zygomatic complex and orbit maxfac tutorial.
A zygoma fracture is often the result of facial trauma such as violence, falls or automobile accidents. A new classification of zygomatic fracture featuring zygomaticofrontal suture. Diagnosis and management of common maxillofacial injuries. A 26yearold man with a slightly dislocated fracture of the zygoma associated with trismus, and localized pain in. Pdf most of the documents on the racgp website are in portable document format pdf. Management of zygomaticomaxillary complex zmc fractures should be based on injury patterns and not on training background. Pdf background zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Symptoms include flattening of the face, trismus reduced opening of the jaw and lateral subconjunctival hemorrhage. Tripod fracture fracture of zygomatic arch, lateral and inferior orbital rims, and lateral wall of maxillary sinus. No obvious complication was recorded during the 24month followup.
There are risks and complications with this procedure. Pdf zygomatic arch fracture with coronoid impingement. Our patients are instructed to remain on a soft diet for 23 weeks after surgery and to avoid exertion for 36 weeks. Although further investigation on this technique might be needed, this report illustrated the feasibility and treatment advantages of our modified method in selective displaced tripod zmc fracture cases. Late correction following zygoma fracture thanks for your question. Note the bone graft arrow this was to make good a continuity defect. Fracture of the zygomatic bone is a common fracture of the facial skeleton. Need to allow the swelling to go down and if that is the only issue, then surgery is not needed, but there could be cartilage damage in the nose area and that requires a physician exam to make a decision. The management of the zygomatic arch and zmc fractures should be.
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