Investigate the risk of earassociated diseases after zygomaticomaxillary complex zmc fracture in a populationbased retrospective cohort study. 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. These fractures occur most commonly as the result of assaults or motor vehicle collisions. For many years, 2point fixation at the frontozygomatic suture and the infraorbital rim using interosseus wiring was the mainstay for treating zygoma fractures. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the zygomatic bone. Pdf management of zygomaticmaxillary fracture the principles.
Pdf surgical methods of zygomaticomaxillary complex fracture. Surgical management of zygomatic complex fractures in a major. 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 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. I was standing too close during his backswing and was hit in the cheek by his driver. Ipsilateral eye may appear to tilt due to pulling of lateral canthus. The zygomatic arch is the third most common fractured facial bone, with a high majority of those cases being male. 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. Because of the various defects of malarplasty, including a large incision, much bleeding, visible scars after the operation, and so on, caused by the conventional coronal incision or the temporal incision with. The incidence, cause, age, and gender predilection of zygomatic. Jun 07, 20 zygoma plays an imp role in facial contour. Ct image of the same patient after cheekbone fracture repair. Frequency of blindness due to zygomatic fracture in hazrat. Evaluation of treatment of zygomatic bone and zygomatic arch.
Fractures of zygomatic complex and orbit maxfac tutorial. Fraktur zygomatic pdf definitions zygoma is a very crucial component which maintains facial contour. And because of its prominent and projected position, it is one of the most prevalent sites of fracture in face, maybe the most prevalent after nasal. Jan 02, 2015 fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressed fracture or a small dimple. What are my treatment options for a cheek fracture. Mildly displaced comminuted fracture of the left zygomatic arch shows up to 37 degrees of inwards angulation. Reduction of fractured zygoma is done by manipulating the broken cheek bone to restore the contour and appearance of the face. These files will have pdf in brackets along with the filesize of the download. Here the fractured zygoma is part of a wider fracture configuration. Jun 28, 2019 basilar skull fracture blowout fracture mandibular omnteggia nasal fracture le fort fracture of skull zygomaticomaxillary complex fracture zygoma fracture. Head and facial trauma the atlas of emergency medicine.
For complex zygomatic fractures, the coronal approach allows for extensive degloving of the facial bones. A basilar skull fracture is basically a linear fracture of the skull base. Broken zygomatic bone recovery doctor answers, tips. The lack of comparative studies is likely explained by the high number of patients needed to attain the appropriate study power. Pdf most of the documents on the racgp website are in portable document format pdf. The initial pain was severe and i felt like there was a popping sensation. I ended up going to the emergency room where i was told that i had a cheekbone zygoma fracture and would have to see a specialist for its repair.
I repair zygoma fractures all the time at our local trauma center. 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. Fracture zygoma and its management our experience core. If you do not have it you can download adobe reader free of charge. Management of zygomatic fractures pocket dentistry. Although studies differ regarding the incidence of these fractures, our experience in the adult population has demonstrated that. 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. Zygomatic complex fracture is the second most common fracture of facial region just. Tripod fracture fracture of zygomatic arch, lateral and inferior orbital rims, and lateral wall of maxillary sinus. The zygomatic arch is formed by the union of the temporal process of the zygomatic bone and the zygomatic process of the temporal bone at the zygomaticotemporal suture.
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. Evaluation of treatment of zygomatic bone and zygomatic. The code is valid for the year 2020 for the submission of hipaacovered transactions. Poor reduction and fixation of zygomatic fractures will result in a number of functional and aesthetic complications, the most disturbing of which is the persistence of diplopia. These will stay in place unless they cause problems, in which case a second operation will be required to remove them. Limitation of jaw movement and flattening of the cheek are produced by depressed fractures of the. Arch fractures are more likely to involve some form of lateral. Facial fracture management handbook malar complex fractures. Moreover the importance of zygomatic complex in facial skeleton lies inprotecting globe of eye and absorbing and redistributing masticatory andexternal load. Therefore for cosmetic and functional reasons it is imperative to diagnoseand treat zygomatic fractures adequately. Risks of a orbito zygomatic maxillary fracture repair there are risks and complications with this procedure. Must distinguish zygomatic arch fracture from zygomaticomaxillary tripod fracture.
Because these ideal measurements are not always found, an examination of the contralateral zygoma will determine the correct position of the injured zygoma in every patient who has no craniofacial anomalies. Head and facial trauma the atlas of emergency medicine, 4e. A new classification of zygomatic fracture featuring zygomaticofrontal suture. When a forearm fracture is identified, dedicated imaging of both the elbow and the wrist is important and good quality ap and lateral views are essential. Related pathology le fort type 3 fracture zygomaticomaxillary complex fra. 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. Lateral wall fractures are therefore more commonly seen following significant maxillofacial trauma involving the malar complex too. Bony union between the coronoid process cp and the zygoma is a very rare cause of extraarticular temporomandibular joint ankylosis1. 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. Orbitozygomatic fractures represent a type of maxillofacial injury that happens very often due to the. Classification and treatment of zygomatic fractures. Symptoms include flattening of the face, trismus reduced opening of the jaw and lateral subconjunctival hemorrhage. The term malar complex fracture refers to a fracture which in its classic form primarily involves the suture lines of the zygomatic bone.
Fractures of the zygomatic complex and arch pocket. Zygoma, zygomatic fracture, blindness, orbit, optic nerve. This term fails to recognize the posterior relationship of the zygoma with the sphenoid bone of the skull base and its extension inferiorly down the lateral wall of the maxillary sinus. We present a case of fracture zygoma who developed epiphora after reduction and fixation of the inferior orbital margin by a miniplate. Management of tripod fractures zygomaticomaxillary. All patients were treated by open reduction and rigid. To open a pdf file you will need compatible software such as adobe reader. Retrospective clinical and radiographic evaluation of tilted implants used in the. Treatment and complications of orbitozygomatic fractures scielo. Other fracture patterns, include isolated zygomatic arch fractures, or zmc fractures with associated panfacial fractures, such as le fort ii and iii. The ages of the patients ranged from 10 to 76 years old, mean age was 32. It may result from facial fractures caused by gunshots, 2 treated or untreated fractures of the zygoma complex 3 4 5 with or.
Dec 28, 2011 regarding the results in group a patient with zygomatic bone fracture were divided into. The zygomatic arch and complex play a significant role in the structure and function of the face. The fracture will be realigned and then fixed together using titanium plate and screws. I went to see my doctor and he said that i most likely had a zygoma cheekbone fracture but that it would heal on its own. The surgical treatment of fracturedislocations of the zygoma and zygomatic arch has a long and interesting development. Trauma resulting in fractures to this area typically does not have localizing symptoms. There are risks and complications with this procedure. The stability of the reduction determines the type and number of fixation sites. The zygomatic bone occupies a prominent and important position in the facial skeleton. Displaced fractures of the zygomatic bone can result in significant functional and aesthetic sequelae. 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. Pdf background zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. The zygoma may be separated from its 4 atriculations. Zygomatic fractures are common facial injuries, representing the most common facial fracture 214 or the second in frequency after nasal fractures.
Fractures of the cheek bone zygomatic complex fractures. Management of tripod fractures zygomaticomaxillary complex 1 point and 2 point fixations. Risks of a orbitozygomatic maxillary fracture repair there are risks and complications with this procedure. Early stabilization is important to maximize both cosmetic integrity and anatomical functionality 1. 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. Of the 47 fracturedislocations of the zygoma, only 3 6% in which the zygo matic arch was also fractured and depressed showed this sign. A few days ago i was playing soccer with my friends and was accidentally kicked in the face.
Analysis of outcome of zygomatic fracture management. Fractures typically occur across these three buttressrelated sutures, leading to the term tripod fracture. Risk of earassociated diseases after zygomaticomaxillary. Late correction following zygoma fracture thanks for your question.
Anatomical fracture patterns and the nuances of clinical presentations are discussed. Our patients are instructed to remain on a soft diet for 23 weeks after surgery and to avoid exertion for 36 weeks. Indirect signs of the injury may include visible evidence of bleeding from the fracture into surrounding soft tissue, such as a battle sign or raccoon eyes. 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. There were 552 86% zygoma frac tures and 90 14% zygomatic arch fractures. Zygomatic complex fractures and its management acta scientific. Open reduction of zygoma fractures with the extended transconjunctival approach and tbar screw reduction article pdf available in archives of plastic surgery 454. This is a retrospective cohort study using taiwans national health insurance research database of. According to the site of fracture, the patients were divided into three groups.
Anatomic, clinical, surgical, and radiographic correlation of the. Zygomatic fractures american academy of ophthalmology. Sometimes patients are given antihistamines and nasal decongestants as well. 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. Apr 27, 2014 the zygoma may be separated from its 4 atriculations. The zygoma anatomyguided approach zaga and the zygomatic success code zsc aparicio c, arevalo jx, ouazzani w, granados c. Pdf open reduction of zygoma fractures with the extended. A zygoma fracture is often the result of facial trauma such as violence, falls or automobile accidents. Fractures of the zygomatic arch za or any of its bony articulations can cause significant functional and cosmetic morbidity. Injury to this facial bone was most likely recognized for many years before the appearance of records on the subject.
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. Basilar skull fracture blowout fracture mandibular omnteggia nasal fracture le fort fracture of skull zygomaticomaxillary complex fracture zygoma fracture. A new classification of zygomatic fracture featuring. Definitions zygoma is a very crucial component which maintains facial contour. Zygoma is a four quadrant bone, which is located in middle part of face.
Feb 27, 2019 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. Treatment goals focus on reduction to reestablish normal orbital volume and adequate fixation, preferably threepoint. Fractures can involve any of the four articulations of zygoma which include zygomaticomaxillary complex, zygomatic complex proper, orbitozygomatic complex. Classification and treatment of zygomatic fractures joms.
Sep 28, 2019 definitions zygoma is a very crucial component which maintains facial contour. Dec 03, 2018 the zygomatic bone occupies a prominent and important position in the facial skeleton. The effect of intraoperative imaging on restoration of facial symmetry and fracture reduction in zmc fracture repair has, to our knowledge, not been assessed comparatively or longitudinally in any paper. 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. If you have any other questions that the leaflet does not answer, or if you would like. Complications of zygomatic bone and zygomatic arch plastic. Jul 15, 2019 definitions zygoma is a very crucial component which maintains facial contour. The majority of cases of cheekbone fracture, such as this specific golf injury, fall into the second scenario where there has been fragment displacement but no damage to vital or critical structures.
Pdf mechanical trauma to the face may cause complex fracture of the zygoma and the maxilla. For complex zygomatic fractures, multiple approaches are often needed for visualizing the fracture sites and applying internal fixation. Note the bone graft arrow this was to make good a continuity defect. The malar complex refers to the zygoma and maxillary bones and therefore forms part of the orbital floor and lateral orbital wall. The relatively severe complication of the zygoma reduction plastic surgery is the zygomatic bone and zygomatic arch displacement or defect. Other possible functional deficits that may occur include limitation of mouth opening and lower eye lid retraction.
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