Midface fractures are common sequelae of motor vehicle accidents, falls, assaults, and other blunt trauma, 1, 2. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the zygomatic bone. Fracture of the zygomatic complex is one of the most common facial injuries in maxillofacial trauma and. Ppt zygomatic complex fractures powerpoint presentation. They are the second most common facial bone fracture after nasal bone fractures pathology. We report a case of a patient with a 9day history of trismus measured at 9 mm figure 1. Xrays of the facial bones showed a depressed fracture of the zygomatic arch with a medial rotation of the zygomatic complex figure 2. This is most commonly seen after assault, but any blow to the cheek may give rise to a fracture. Fracture of the zygomatic complex is one of the most common facial injuries in maxillofacial trauma and predominately appears in young adult. 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. A complex fracture is when the bone is broken into many pieces and the. Classification and management of zygomatic complex fractures including lateral wall of the orbit. Treatment methods for complex fractures premier orthopaedics. Zygomatic complex fractures or tripod fractures are the second most common fractures after nasal fractures among facial injuries.
Musculoskeletal s tructures and f unction the s keletal s tructures modern orthopaedics is concerned with the diagnosis and management of disorders of the musculoskeletal system, that is the skeleton and. Surgical navigation improves reductions accuracy of. They were divided into four groups of 10 patients each, group i. The role of intraoperative ultrasonography in zygomatic. Reduction of zygomatic fractures using the carrollgirard. The treatment of humeral fractures is a complex issue and the source of.
Pdf reconstruction of complex zygomatic bone defects. Zygomatic complex fractures free download as powerpoint presentation. 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. Gillies temporal approach has been a commonly used technique for zygomatic arch reduction, but surgeons have been commonly using a buccal sulcus approach for the reduction of zygomatic arch fractures as well as for combined. Fracture is a free buffer effect geared toward creating robotic artifacts and musical malfunctions. Nonrandomized, prospective management of facial trauma patients. An anterior zygomatic implant, together with posterior conventional implants, can solve the problem. Computed tomography ct has become the imaging standard of reference in evaluating these injuries to determine which patients will require surgical intervention for their bony injuries, 3, 4. Single transconjunctival incision and twopoint fixation. Zygomatic complex zmc fractures are one of the most common facial fractures seen in trauma centers. Inadequate bone in zone 1 and adequate pristine bone in zones 2 and 3. Complicated zygomaticomaxillary complex fracture, known as one of the most challenging facial bone fractures, is. In zygomaticomaxillary complex zmc fracture many incisions lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary. The zygomatic bone has a quadrilateral shape with several processes that articulate with the frontal bone via frontozygomatic zf suture, the maxilla via.
A rare case report manikandhan ramanathan, mathew pynumootil cherian, 2010. Additionally, the fracture components may result in impingement of the. Inadequate bone in zones 1, 2 or 3 in a partially edentulous patient. Four zygomatic implants can be used for the rehabilitation. This plugin was designed to add glitchy articulations and abstract textures to your projects. Although studies differ regarding the incidence of these fractures, our experience in the adult population has demonstrated that. This pdf is available for free download from a site hosted by medknow publications. Zygomatic fractures are considered as the second most common type of facial fractures following nasal fractures. Early and delayed repair of orbitozygomatic complex fractures. Note the flattening of the malar process on the left hand side of the face.
Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and. Acute intraorbital hemorrhage following reduction of a displaced. It is always challenging for maxillofacial surgeons who are specialized in treating this part of the human body to achieve the lost functions and regain proper facial contour. Zygomatic complex fractures musculoskeletal system. Spectrum of critical imaging findings in complex facial. A free powerpoint ppt presentation displayed as a flash slide show on id. Oral surg oral med oral pathol oral radiol endod 1094. Assessment of the position of the zygoma at additional fracture sites i. As a consequence of our handsoff approach to the zygomatic arch, we rarely, if ever, use a coronal incision for a zygomaticomaxillary complex fracture. Fracture is a versatile effects processor geared toward electronic musicians and sound designers. Commentary on surgical management of zygomatic complex. Surgical management of zygomatic complex fractures in a. If a fracture modifies the anatomy or function of the glenohumeral and.
Patients and methods fifteen superior cantholysis procedures were used in 14 patients who presented with zmc fractures requiring open reduction and internal fixation. The aim of this research was to analyze the surgical approaches and methods of rigid fixation used to treat zygomatic complex zc fractures. The zygomatic arch and complex play a significant role in the structure and function of the face. Two point fixation in zygomatic complex fractures doi. Accurate reduction is the key to successful treatment of bone fractures. The contour of the zygomatic arch reflects the relationship of the zygomatic bone to the skull base, and is the most reliable indicator of the anterior projection of the zygoma11, 21. The distinct imprint on the side of his face was caused by a zygomatic arch fracture. Management of zygomatic complex fracture in armed forces. The surgical treatment of displaced craniofacial fractures centers. Untreated fractures may cause a cosmetic deformity flattening of the cheek or limited mandibular movement caused by the depressed zygoma impinging on the coronoid process of the mandible. Fractures of the body of the zygomatic complex with rotation in theanteroposterior direction4a.
We have developed a new reduction technique called lever, which is based on the application of lifting force as an alternative to the methods in which the pulling force is applied. Zygoma fractures are easy to miss and displaced fractures require treatment within 10 days. Surgical methods of zygomaticomaxillary complex fracture ncbi. Zygomaticomaxillary complex fracture radiology reference. View zygomatic fracture ppts online, safely and virus free. Superior cantholysis for zygomatic fracture repair. We recommend threepoint rigid fixation of fractured zygoma after accurate reduction. T reatment of zygomatic complex fractures with surgical or. The guest edited thematic issues are published free of charge. The trismus occurred immediately after an alleged assault with punch injuries to the face.
To develop objective criteria with which to identify patients with zygomatic complex zmc or midface fractures who require a surgical exploration and treatment of the orbital component of their fracture to prevent postoperative enophthalmos, diplopia, or malar depression. Fractures of the body of the zygomatic complex without rotation in theanteroposterior direction z axistype 4. These fractures can occur from sports accidents, assaults, falls, motor. In midfacial fracture repair the alignment of the zygomatic arch is very important. Orbitozygomaticomaxillary complex ozmc fractures are commonly. Zygomatic complex fractures fracture of the zygomatic complex and arch. A zygomatic fracture is a fracture of the cheekbone caused by a direct blow to the cheek. Novel surgical technique for repair of zygomatic fractures. The next day he had surgery to repair a cheekbone fracture. Diagnosis and management of common maxillofacial injuries. Definitions zygoma is a very crucial component which maintains facial contour. Researcharticle anatomical thin titanium mesh plate structural optimization for zygomatic maxillary complex fracture under fatigue testing yutzuwang,1 shaofuhuang,1 yutingfang,2 shouchiehhuang,2 hweifangcheng,2 chihhaochen,3,4 pofangwang,5 andchunlilin 1 departmentofbiomedicalengineer,nationalyangminguniversity,taipei,taiwan.
A zygoma fracture is often the result of facial trauma such as violence, falls or automobile accidents symptoms include flattening of the face, trismus reduced opening of the jaw and lateral subconjunctival hemorrhage see also. This is an unusual case of isolated bilateral zygomatic complex and arch fracture, which is extremely rare. The surgical approach for adequate reduction of zygomatic complex fractures must provide maximum. Zygomaticomaxillary complex fractures present a challenging diagnostic and reconstructive task to the surgeon. In the case of comminuted fractures of the arch, one can simply slide the previously placed bone hook under the fractured arch segments and reduce them in a closed fashion. Zygomatic fractures can also lead to disarticulation from the suture line along the four articulation surfaces i. Facial fractures are commonly caused by blunt or penetrating trauma sustained during motor vehicle. Objective to determine if performing a superior cantholysis eases the surgical exposure, reduction, and rigid fixation of the zygomaticofrontal suture in the open repair of zygomatic complex zmc fractures.
Facial fractures account for a large number of emergency department visits in the united states and are associated with substantial levels of morbidity and mortality due to damaged facial structures, associated complications, and trauma sustained by other parts of the body. Complex fracture nucleation and evolution with nonlocal. Zygomatic fractures should be treated early because they can cause both functional and cosmetic defects. Kharkar vr, rudagi bm, halli r, kini y 2010 comparison of modified lateral orbitotomy approach and modified hemicoronal approach in the treatment of unstable malunions of zygomatic complex fractures. Understanding the anatomy of the cheek bone, technically known as the zygomaticoorbital complex, will explain the specific type of facial fracture this nba player sustained. Displaced malar complex fractures may increase orbital volume due to angulation of the zygomaticosphenoid suture or orbital floor blowout.