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Zygomatic Fracture

Zygomatic zygomatic arch fracture type 4 (dislocated fracture of zygomatic bone with diastase is available on the lateral orbital rim) with dorsokaudaler shear


Presentation

  • There are many surgical approaches that can be used to expose the nasal bones, but we present a case where the subciliary incision was used to reduce and fixate the fracture in a patient with combined zygomatic fractures.[ncbi.nlm.nih.gov]
  • The present technique has several advantages such as that (a) only 1 incision is necessary to approach the zygomaticomaxillary buttress and infraorbital rim, (b) it optimizes surgical time, and (c) it avoids periorbital scars.[ncbi.nlm.nih.gov]
  • The technique of endoscopically assisted fracture repair was then applied to a clinical series of consecutive patients presenting with displaced zygomatic fractures with comminution at the malar arch.[ncbi.nlm.nih.gov]
  • PATIENTS AND METHODS: Fifteen superior cantholysis procedures were used in 14 patients who presented with ZMC fractures requiring open reduction and internal fixation. Follow-up ranged from 6 to 18 months.[ncbi.nlm.nih.gov]
Trismus
  • Presentation Arch fractures may result in trismus, flattening of the midface, asymmetry of the malar regions, or a reduction in oral aperture.[oralmaxillo-facialsurgery.blogspot.com]
  • 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 hypoaesthesia within its sensory distribution.[radiopaedia.org]
  • Severe displacement may cause direct impingement on the coronoid process, however, and trismus is more pronounced leading to interincisor distance of 1cm.[medicine.uiowa.edu]
  • Facial bruising, periorbital ecchymosis, soft tissue gas, swelling, trismus, altered mastication, diplopia, and ophthalmoplegia are other indirect features of the injury. [1] The zygomatic arch usually fractures at its weakest point, 1.5 cm behind the[en.wikipedia.org]
Chewing Problem
  • There has been no case of chewing problems, cheek numbness or progressive enophthalmos developing postoperatively.[ncbi.nlm.nih.gov]
Fracture
  • Nasal bone fracture is the most common of the fractures of the facial skeleton.[ncbi.nlm.nih.gov]
  • , including adequacy of fracture reduction.[ncbi.nlm.nih.gov]
  • This technique was used in 15 consecutive patients including 2 with isolated zygomatic arch comminuted fractures and 13 having displaced zygomatic fractures with segmental, displaced zygomatic arch fractures.[ncbi.nlm.nih.gov]
  • We applied a navigation system in 6 patients with zygomatic bone fracture.[ncbi.nlm.nih.gov]
  • RESULTS: There were 552 (86%) zygoma fractures and 90 (14%) zygomatic arch fractures. The left zygoma was involved in 309 cases (56%); the right zygoma was involved in 243 cases (44%).[ncbi.nlm.nih.gov]
Diplopia
  • Diplopia fails to resolve after 2-3 weeks. Complications Globe injury. Persistent diplopia requiring delayed surgery. Optic nerve damage. Medial orbital wall fracture Features These are rare in isolation but may accompany orbital floor fractures.[patient.info]
  • Symptoms Unilateral periocular haematoma Subconjunctival haemorrhage Swelling Flattened face (sometimes) Palpation Infraorbital fracture steps Lateral orbital border Zygomatic buttress Function tests V2 sensitivity Facialis function Ocular motility Diplopia[med-college.hu]
  • Diplopia. Diplopia is the name given to the symptom of blurred vision. Two varieties of diplopia exist; it is important to distinguish between them.[pocketdentistry.com]
  • The first type is chiefly characterized by the involvement of the orbit, and often there is some ocular dysfunction such as diplopia, dystopia or enophthalmos.[rbcp.org.br]
Enophthalmos
  • There has been no case of chewing problems, cheek numbness or progressive enophthalmos developing postoperatively.[ncbi.nlm.nih.gov]
  • Enophthalmos (the eye is sunken). Infraorbital anaesthesia (lower lid, cheek, side of nose, upper lip, upper teeth and gums).[patient.info]
  • The first type is chiefly characterized by the involvement of the orbit, and often there is some ocular dysfunction such as diplopia, dystopia or enophthalmos.[rbcp.org.br]
Facial Edema
  • Second, if surgery must be performed while excessive facial edema is present, surgical exposure to determine the position of the ZMC is helpful.[pocketdentistry.com]
  • CASE REPORT A 21-yr-old man presented at our department with the chief complaint of right facial edema and deformity that occurred after a blow to the facial area.[e-ceo.org]
  • Majority of the patients in this study had middle-energy fractures which are similar to those reported by other authors.[ 8 , 9 ] Facial edema and peri-orbital swelling may hamper clinical examination and immediate surgical procedure among these patients[parjournal.net]
Facial Pain
  • For example, nerve diseases like trigeminal neuralgia or Bell's palsy sometimes cause facial pain, spasms and trouble with eye or facial movement. Birth defects can also affect the face.[icdlist.com]

Treatment

  • Abstract A review of classifications of zygomatic fractures demonstrates an increasing complexity in the choice of proper treatment.[ncbi.nlm.nih.gov]
  • Balle V, Christensen PH (1982) Treatment of zygomatic fractures: a follow-up study of 105 patients. Clin Otolaryngol 7(6):411–416 PubMed CrossRef 2. Bosniak Sl, Tizes Br (1987) Trimalar fractures: diagnosis and treatment.[springermedizin.de]
  • In all probability many instruments and methods were devised and used for surgical treatment without being recorded.[jamanetwork.com]
  • The treatment performed for all patients was reduction and fixation with titanium miniplates.[jstcr.org]
  • Baek, Jung, Kim, and Kang: Delayed Treatment of Zygomatic Tetrapod Fracture Abstract Since maxillofacial injury is frequently accompanied by other diseases, its evaluation and treatment are open delayed.[e-ceo.org]

Prognosis

  • […] temporozygomatic suture fractures of the inferior orbital rim and anterior and posterior maxillary sinus walls and/or diastasis of the zygomaticomaxillary suture fracture of the lateral orbital rim and/or diastasis of the frontozygomatic suture Treatment and prognosis[radiopaedia.org]
  • Gillie's approach is used for depressed zygomatic fractures. [4] The prognosis of tripod fractures is generally good.[en.wikipedia.org]
  • Prognosis Good prognosis is suggested by: Union of bones. Lack of any deformity. Full range of mandibular movement.[patient.info]
  • Prognosis is usually good. Jaw (mandibular) fracture: Prognosis is usually good. Midface (maxillary) fracture People with midface fractures have a poorer prognosis because of other injuries suffered from the accident that caused their fracture.[emedicinehealth.com]
  • […] requires surgical intervention. [7] Age Most cases of zygomatic complex fractures occur in young patients in their second to third decades of life, with the exception of fractures due to accidental falls, which are mainly seen in older patients. [7, 8] Prognosis[emedicine.medscape.com]

Etiology

  • BACKGROUND AND OBJECTIVES: The aim of this paper is to investigate epidemiological data (age, gender), sites, etiology and surgical approach of zygomatic fracture.[ncbi.nlm.nih.gov]
  • Iannetti Etiology and incidence of zygomatic fracture: a retrospective study related to a series of 642 patients Eur Rev Med Pharmacol Sci Year: 2012 Vol. 16 - N. 11 Pages: 1559-1562[europeanreview.org]
  • Results: Most of the patients were male (90.0%), the most frequent etiology was a motorcycle accident (70.0%) and the left side was more affected (60.0%).[jstcr.org]
  • , the incidence and etiology varies from country to country.[pubs.sciepub.com]
  • Etiology Zygoma fractures usually result from high-impact trauma. Leading causes of fractures include assault, motor vehicle or motorcycle accidents, sports injuries, and falls.[oralmaxillo-facialsurgery.blogspot.com]

Epidemiology

  • BACKGROUND AND OBJECTIVES: The aim of this paper is to investigate epidemiological data (age, gender), sites, etiology and surgical approach of zygomatic fracture.[ncbi.nlm.nih.gov]
  • Iannetti Department of Maxillo-Facial Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy. emiliano.riccardi@hotmail.it BACKGROUND AND OBJECTIVES: The aim of this paper is to investigate epidemiological data (age, gender), sites, etiology[europeanreview.org]
  • Changing patterns in the epidemiology and treatment of zygoma fractures: 10-year review. J Trauma . 1994 Aug. 37(2):243-8. [Medline] . Rallis G, Stathopoulos P, Igoumenakis D, Krasadakis C, Mourouzis C, Mezitis M.[emedicine.medscape.com]
  • Covington D.S , D.J Wainwright, J.F Teichgraeber and D.H Parks.Changing patterns in the epidemiology and treatment of zygoma fractures:10 year review. J Trauma 1994;37(2):243-248. Poswillo D.Reduction of the fractured malar by a traction hook.[pacificejournals.com]
  • Changing patterns in the epidemiology and treatment of zygoma fractures: 10-year review. J Trauma. 1994 Aug. 37(2):243-8. [Medline]. Manson PN, Clark N, Robertson B, et al.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The Whitnall tubercle, which serves a critical role in the maintenance of eyelid contour as the attachment site for the lateral canthal tendon, is located on the zygomatic bone 2 mm behind the lateral orbital rim. [3] Pathophysiology The zygoma is the[emedicine.medscape.com]
  • Zygoma Fracture (Simple) General Information Zygoma is 2nd most common facial bone fractured Usual causes of arch fractures MVC or altercation Sports injuries Falls Pathophysiology A low impact injury Requires only 50 Gs Fracture pattern Usually 3 fractures[fprmed.com]
  • Posteriorly the zygoma articulates with the sphenoid bone Pathophysiology: The zygomatic bone acts as an important buttress between the maxilla and skull. Its prominent location makes it prone to fracture during injuries to facial skeleton.[drtbalu.co.in]
  • Other associated facial fractures occur in 25% of patients who sustain ZMC fractures. [3] Pathophysiology See Relevant Anatomy for a discussion of the impact of zygomaticomaxillary complex (ZMC) fractures on other facial structures.[emedicine.medscape.com]
  • Associated with these technical and surgical advances, is the in-depth understanding of pathophysiology of fractures.[dmrjournal.org]

Prevention

  • Early evaluation and timely intervention can avoid unnecessary treatments and prevent postoperative complications.[e-ceo.org]
  • In isolated posterior fractures, the infraorbital nerve may block the surgical field, preventing visualization of the fracture site.[docksci.com]
  • This is our super secret invisible way of preventing robots from spamming the email of the organizer! Required Comment Your submission has been sent. Send Message *Please report fraud and Terms of Service violations only.[youcaring.com]
  • Data were organized with the aid of Epi-Info version 3.4 (Centers for Disease Control and Prevention, Atlanta, GA, USA). Descriptive statistics techniques were also used by means of absolute and percentage distributions.[jstcr.org]
  • Pearl RM (1990) Prevention of enophthalmus: a hypothesis. Ann Plast Surg 25:132–133 Google Scholar 35.[link.springer.com]

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