zygomatic bone fractures presentation.ppt

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1. Maxillofacial TraumaMaxillofacial Trauma
Zygomatic bone fractureZygomatic bone fracture

2. AnatomyAnatomy
The middle third face is composed of
bones:
1.Vomer (1)
2.Maxilla (2)
3.Zygomata (2)
4.Nasal (2)
5.Lacrimals (2)
6.Palatines (2)
7.Inferior Nasal Conchae (2)

3. AnatomyAnatomy

4. AnatomyAnatomy

5. The ZygomataThe Zygomata
Paired
Form the “cheekbones”
Articulate with the temporal, frontal, and
maxillary bones
Their prominent position and shape renders
them susceptible to injury

7. Zygoma FracturesZygoma Fractures
The zygoma has 2 major components:
–Zygomatic arch
–Zygomatic body
Blunt trauma most common cause.
Two types of fractures can occur:
–Arch fracture (most common)
–Tripod fracture (most serious)

8. Zygoma Arch FracturesZygoma Arch Fractures
Can fracture 2 to 3 places along the arch
–Lateral to each end of the arch
–Fracture in the middle of the arch
Patients usually present with pain on
opening their mouth.

9. Zygoma Arch FracturesZygoma Arch Fractures
Clinical FindingsClinical Findings
Palpable bony defect
over the arch
Depressed cheek with
tenderness
Pain in cheek and jaw
movement
Limited mandibular
movement

12. Zygoma Arch FracturesZygoma Arch Fractures
Imaging Studies & TreatmentImaging Studies & Treatment
Radiographic imaging:
–Submentovertx view

13. Zygoma Tripod FracturesZygoma Tripod Fractures
Tripod fractures
consist of fractures
through:
–Zygomatic arch
–Zygomaticofrontal
suture
–Inferior orbital rim and
floor

14. Zygomatic FracturesZygomatic Fractures
Signs & Symptoms:
–Pain
–Numbness of the cheek, infraorbital region &
upper teeth on injured side
–Eyelid swelling
–Inability to close mouth properly
–Swelling, Edema, Ecchymoses
–Flattened cheekbone
–Palpable depression at fracture site

15. Zygoma Tripod FracturesZygoma Tripod Fractures
Clinical FeaturesClinical Features
Clinical features:
–Periorbital edema and
ecchymosis
–Hypesthesia of the
infraorbital nerve
–Diplopia
–globe injuries are
common

19. Zygoma Tripod FracturesZygoma Tripod Fractures
Imaging StudiesImaging Studies
Radiographic imaging:
–Waters, Submentovertx
and Caldwell views
Coronal CT of the
facial bones:
–3-D reconstruction

22. Zygoma Tripod FracturesZygoma Tripod Fractures
TreatmentTreatment
Nondisplaced fractures without eye involvement
–Ice and analgesics
–Delayed operative consideration 5-7 days
–Decongestants
–Broad spectrum antibiotics
–Tetanus
Displaced tripod fractures usually require
admission for open reduction and internal fixation.

26. TreatmentTreatment
Open reduction
Internal fixation