Pdf pattern of zygomatic complex bone fracture in saudi arabia. It forms a large portion of the orbit and, together with the sphenoid bone, forms part of the orbital floor. Pdf delayed treatment of zygomatic tetrapod fracture. 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. Zygomaticomaxillary complex fracture radiology reference. 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. All zygomatic complex fractures involve the orbital floor and therefore understanding of. Fractures of zygomatic complex and orbit introduction 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. In this study, the researchers describe a new means of classifying zygomatic fractures based on 3dct and the type of trauma inflicted, which could be used to inform surgical strategy. It is situated at the upper and lateral part of the face and forms the prominence of the cheek, part of the lateral wall and floor of the orbit, and parts of the temporal fossa and the infratemporal fossa. Zygomatic branches of the facial nerve an overview. Zygomatic fractures rotate down and inward resulting in a cheek deficiency and an orbital lowering if left unrepaired. A new classification of zygomatic fracture featuring. Reconstruction of complex zygomatic bone defects using mirroring coupled with ebm fabrication of titanium implant article pdf available in metals open access metallurgy journal 912.
This is zygomatic arch fracture reduction using a temporal approach. The aim of this study is to present pattern of zygomatic bone fracture in a peculiar environment. The ages of the patients ranged from 10 to 76 years old, mean age was 32. The temporal bone is the bone that goes around your ear, in your skull. Pdf treatment of zygomatic complex fractures with surgical or. Zygomatic complex fracture or cheek bone fracture correction video. Those zmc fractures often involve damage to the orbital floor andor the medial.
Management of zygomatic fractures pocket dentistry. Surgical treatment of zygomatic bone fracture using two. Delayed treatment of zygomatic tetrapod fracture article pdf available in clinical and experimental otorhinolaryngology 32. The patient never suffered any discomfort or presented any problems in the operative site before the fracture. The zygomatic bone is small and quadrangular, and is situated at the upper and lateral part of the face. Because of its position, it is the second most common midfacial bone fractured after the nasal bones and overall represents % of all craniofacial fractures 1, 2. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Local soft tissue increase and oft tissue emphysema. Pdf objective evaluate the 1year treatment outcome of zygomatic complex fractures. Evaluation of treatment of zygomatic bone and zygomatic.
An ice pack and pain relievers may be recommended to manage pain and swelling as the fracture heals. Depending upon the extent of the bone displacement, the zygomatic complex can be refractured osteotomized and reposiitoned back. The zygomatic arch is formed by the articulation of the temporal process of the zygoma and the zygomatic process of the temporal bone. Any patient who did not undergo a preoperative ct scan with 0. Nonetheless, combining ultrasonography with ct scanning allows for. As long as the zygomatic arch isnt creating a functional or cosmetic issues, it is best to leave it alone. A zygoma fracture zygomatic fracture is a form of facial fracture caused by a fracture of the zygomatic bone. Postoperative infection caused by a resorbable plate used.
Adequate reduction of a zygomatic complex fracture remains a challenge for surgeons, due to its. Zygomatic complex fractures are one of the frequently occurring maxillofacial injuries owing to its position and facial contour. The zygomatic bone, in particular the malar eminence, plays an important part in the appearance of our faces. Zmc fractures remain the most common facial fracture behind nasal. A new proposal of classification of zygomatic arch fractures. The malar complex is also commonly fractured in isolation by a blow to that area. The infraorbital rim was the most common site for insertion of the plates n70, 77.
It was observed that zygomatic arch fractures were divided into 2 main groups by their radiological and clinical. If displaced fracture, a surgeon does the wiring of the bone, which can be an ent surgeon, a plastic surgeon or general surgeon. Cheek bone fracture tx depends on the extent of the fracture. Pdf introduction zygomatic bone also known as the cheek bone. It adjoins the frontal bone at the outer edge of the orbit and the sphenoid and maxilla within the orbit. For example, a hairline fracture in the cheekbone may simply require time to heal. It forms the central part of the zygomatic arch by its attachments to the maxilla in front and to the zygomatic process of the temporal. Zygomatico maxillary complex fracture internal fixation point fixation.
Zygomatic bone definition of zygomatic bone by medical. It articulates with the zygomatic process of the temporal bone, and together they make up the zygomatic arch. Evaluation of a single miniplate use in treatment of zygomatic bone. Skeletal healing of displaced zygomatic bone fragments after insufficient fracture reduction and fixation results in an inadequate projection of the zygomatic body and thus facial asymmetry. Request pdf botulinum toxin in the treatment of zygomatic fractures reduction of dislocated zygomatic bone fractures when they are left mobile is spoiled by the strong pull of the masseter muscle. 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 body of the zygoma is sturdy, but its articulations are frequently the site of. It articulates with the zygomatic bone this process is at first directed lateralward, its two surfaces looking upward and downward. Fracture zygoma and its management our experience core. Zygomatic arch reduction gillies approach springerlink. Isolated zygomatic arch fractures localized in the zygomatic arch alone type i, 2. On the left the noninjured side overlying structures give the impression of a. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Hence, combining computerassisted surgical navigation for. Botulinum toxin in the treatment of zygomatic fractures. Management of zygomatic complex fractures is a bonafide record of work done by. Does a depressed fracture of the zygomatic arch need to be. The existing techniques for reduction malarplasty cannot change the degree of curvature of the zygomatic arch. Zygomatic fracture and nasal fracture at 6 weeks most bones are fairly well healed into place and will be very difficult to reset them without osteotomies. It serves as an attachment point for the masseter and plays a significant role in maintaining facial contour. Treatment of zygomatic complex fractures with surgical or. Classic tripod fracture, but anatomically these fractures are actually.
Evaluation of the lateral orbital approach in management. Zygomatic arch fracture treatment answers on healthtap. Accurate assessment of the position of the zygomatic bone in relation to the cranial base posteriorly and the midface anteriorly, is the key to the acute. We showed that treatment of an isolated zygomatic bone fracture according to. Neglected orbitozygomaticomaxillary fractures with complications.
The prominence of the zygomatic region predisposes it to bearing the brunt of the facial injuries. We provide a new technique for efficient midfacial width reduction by multiple osteotomies at different sites on the zygomatic complex and bone resection at the most protruding middle part of the zygomatic arch. Zygomatic osteocutaneous ligaments mcgregors patch is a stout band or series of bands that originate from the periosteumbone at the anteroinferior portion of the zygomatic arch, anterosuperior to the perforating branch of the transverse facial artery and possibly a branch of the zygomaticofacial nerve sensory, usually, but not always. Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020. They are the second most common facial bone fracture after nasal bone fractures pathology. The purpose of this study is to evaluate the functional and esthetic outcome following this lateral orbital approach in the management of zygoma fracture. In the human skull, the zygomatic bone cheekbone or malar bone is a paired irregular bone which articulates with the maxilla, the temporal bone, the sphenoid bone and the frontal bone. Chapter 5 a tenyear analysis of midfacial fractures. Tripod fracture consists of a zygomatic arch fracture, b fracture of the lateral orbital wall, and c fracture of the inferior orbital floor. The temporal process, which forms zygomatic arch a1frontal process, which forms lateral orbital wall a2maxillary process, which forms infraorbital rim a3category bfracture of all three processes, detaching zygomatic bone from facial skeleton i. Treatment of zygomatic complex fractures using two point. Assaults, road traffic accidents and falls are the common causes leading to. The face occupies the most prominent position in the human body rendering it vulnerable to injuries quite commonly. The strong central part of the bone usually remains intact and the force is transmitted to the three.
The zygomatic bone occupies a prominent and important position in the facial skeleton. Patients treated for isolated zygomatic fractures at the keio univeristy hospital between 2004 and 2011 were recruited for this study. Each zygomatic bone articulates with the temporal bone, frontal bone, maxilla, and sphenoid bones. This is the socalled classic tripod fracture, but anatomically these fractures are actually tetrapod fractures and should be thus called fig. 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.
In the united states, zygomatic fractures are the second most common fracture of the facial bones following nasal bone fractures. The zygomatic process of the temporal bone is a long, arched process projecting from the lower part of the squamous portion of the temporal bone. In this study, orbitozygomatic, commuted, and zygomatic bone 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. The maxillary bone was the most common to have an associated fracture figure 6. Surgical reduction of zygomatic fractures by an intraoral surgical approach was. Zygomatic arch fracture symptoms answers on healthtap. Fractures involving zygoma is very common, in fact it is the second most common facial bone to the fractured following facial trauma next only to nasal bones. Zygomatic process of frontal bone fracture radiology. Type b complete monofragment zygomatic fracture tetrapod fracture. Osteosynthesis was achieved by a fixation technique using three points along to the orbital rim, the frontozygomatic suture, and the.
Classification and treatment of zygomatic fractures. Pdf reconstruction of complex zygomatic bone defects. Up to 50% of these fractures will heal with no surgery required. Other sites for plate insertion were the zygomaticofrontal junction in 39 patients 43. Zygomatic arch reduction and malarplasty with multiple. Doctor answers on symptoms, diagnosis, treatment, and more. You have two temporal bones, one on each side of your head. 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. Patients with only zygomatic arch fracture or multiple complex fractures were also excluded. 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. Axial bone window there is a simple fracture involving the superior and lateral aspect of the right orbital roof in its anterior portion, precisely on the zygomatic process of the frontal bone.
According to the site of fracture, the patients were divided into three groups. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Jacksonville, fl, usa to fix a zygomatic bone fracture at another general hospital. Definitions zygoma is a very crucial component which maintains facial contour.
The vast majority of zygomatic fractures occur in men in their third decade of life. Zygomatic bone, also called cheekbone, or malar bone, diamondshaped bone below and lateral to the orbit, or eye socket, at the widest part of the cheek. All four pillars of the malar bone are fractured and displacement may occur. The malar complex refers to the zygoma and maxillary bones and therefore forms part of the orbital floor and lateral orbital wall. Treating the zygomatic arch fracture depends upon whether it is displace or caved in. The zygomatic complex also helps in transmitting the occlusal forces to the skull base. Additionally, the fracture components may result in impingement of the. The code is valid for the year 2020 for the submission of hipaacovered transactions. It protects the part of your brain that controls hearing, speech, memory, and behavior. The researchers consider the previous classification system should be improved. However, your oral surgeon will need to perform a clinical exam with ct scan. 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. Trauma xray axial skeleton gallery 1 face zygomatic. The retrospective design introduces information bias.
Facial fracture aftercare instructions what you need. Combined zygomatic arch fractures in which the fracture in the arch was a component of zygomatic bone fracture or of le fort iii level. Some stress fractures or chip fractures can take weight but displaced fractures are too painful and unstable to walk on. Temporal fascia zygomatic bone zygomatic arch temporal muscle instrument 30. Technique hair is shaved baseline gauge external auditory meatus incision 2. Fractures of zygomatic complex and orbit maxfac tutorial.
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