Complex zygomatic fracture

Posted By Wael Nemattalla
Complex zygomatic fracture

29 years old male involved in road traffic accident. Multiple right zygomatic arch fractures are seen with separated bone fragments. Intraarticular fracture of right temporomandibular joint and fracture squamous temporal bone are also seen.

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  • Wael Nemattalla 2013-12-29 07:19:05

    Zygomaticomaxillary complex fracture

    A zygomaticomaxillary complex fracture (which is also known as a tripod fracture,trimalar fracture or malar fracture) is seen in the setting of traumatic injury to the face


    They can account for approximately 40% of midface fractures. They are the second most common facial bone fracture after nasal bone injuries.


    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. Additionally, the fracture components may result in impingement of the temporalis muscle, trismus (difficulty with mastication) and may compromise the infraorbital foramen/nerve resulting in hypesthesia within its sensory distribution.

    Radiographic features

    On radiographic evaluation, typically with dedicated CT imaging with multiplanar reformats, the following three fracture components are generally identified

    1. fracture of the zygomatic arch

    2. fractures of the inferior orbital rim and anterior and posterior maxillary sinus walls and

    3. fracture of the lateral orbital rim

    Treatment and prognosis

    If needed, closed or open reduction methods can be performed with the goal of treatment being preservation of normal facial structure, sensory function, globe postion and mastication functionality.