Zygomatic complex fractures are one of the frequently occurring maxillofacial. A new classification of zygomatic fracture featuring. Fracture mechanics examples fracture mechanics can be applied in a large number of fields. This is the case for linear elastic fracture mechanics lefm. A zmc fracture is also known as a tripod, tetrapod or quadripod fracture, trimalar fracture or malar fracture. Zygomatic complex fracture tripod fracture iowa head. 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. Due to its location, its fracture is the 2 nd frequent fractured bone of midfacial. Zygomaticomaxillary complex fracture aka tripod fracture. These fractures occur most commonly as the result of assaults or motor vehicle collisions. A prospective short clinical study ramesh candamourty 1, vinod narayanan 2, mf baig 2, mr muthusekar 2, manoj kumar jain 3. Diagnosis and management of common maxillofacial injuries in the emergency department. Analysis of fracture and fatigue using a simplified stress wave unloading model and lagrangian mechanics version 2 clive nealsturgess emeritus professor of mechanical engineering university of birmingham.
The fractures that affect the zygomatic process are extremely complex, and the surgeons experience is necessary, since they involve orbit floor 1. Malunited zygomatic complex fracture multiple time operated. Patients with only zygomatic arch fracture or multiple complex fractures were also excluded. Case report threepoint fixation of displaced tripod. Fractures of the cheek bone zygomatic complex fractures. Six cases had mandibular fractures in addition to the displaced zygomatic fracture and one case of fracture involving zygomatic. We help you select the appropriate treatment of zygoma, zygomatic complex fracture located in our module on midface. Fracture mechanics for composites state of the art and challenges ronald krueger national institute of aerospace, hampton, virginia, usa for laminated composite materials, interlaminar fracture mechanics has proven useful for characterizing the onset and growth of delaminations. In 1909, keen was the first to depression and patients with paresthesia of the infra describe an intra oral upper buccal sulcus incision to orbital nerve with fractured zygomatic complex were elevate and reduce the zygomatic complex. Aug 21, 2014 this patient was diagnosed with a left zygomaticomaxillary complex fracture and underwent open reduction and internal fixation via a gingivobuccal sulcus approach. Jan 02, 2015 the most common orbital injury is a blowout fracture, usually involving the orbital floor the medial wall. The methodology involves collecting ct scan data of a patient having zygomatic complex fracture. Case example zygomatic complex fracture tripod fracture.
The incidence, cause, age, and gender predilection of zygomatic. Zygomaticomaxillary complex zmc fractures, also known as tripod, tetrapod, quadripod, malar or trimalar fractures, are seen in the setting of traumatic injury to the face. Zmc fracture management other etiologies in our study included accidental fall, interpersonal violence, occupational injury and sports injury. Jun 07, 20 zygoma plays an imp role in facial contour. Risks of a orbito zygomatic maxillary fracture repair there are risks and complications with this procedure. Introduction many people are aware of the theory of elastic fracture originated by aa griffith in. Zygomaticomaxillary complex fracture radiology case. It has been reported that three point fixation is appropriate for isolated zygomatic bone fracture. Nine cases had isolated fractures of the zygomatic complex with displacement.
The zygomaticomaxillary complex fracture, also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture. The zygomatic complex also helps in transmitting the occlusal forces to the skull base. Zygomaticomaxillary complex fracture tripod fracture return to. Patient perspective in the management of zygomatic fractures. 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. The zygomaticomaxillary complex functions as the principle buttress of the face and is the cornerstone to an individuals aesthetic appearance. Strong buttress of lateral midface lying between zygomatic process of frontal bone and maxilla.
Materials and methods one hundred and fortytwo consecutive patients with. Traumatic findings demonstrate a left zygomaticomaxillary complex fracture or tripod configuration fracture from direct blow to the malar eminence. Consideration 1 indications second most common mid face fracture nasal fracture is first, usually from lateral blunt force like a blow from a fist. Step wise procedure of the gilles temporal approach shown here. Zygoma fractures are easy to miss and displaced fractures require treatment within 10 days. Dec 30, 2017 malunited zygomatic complex fracture multiple time operated fracture and reregid fixation. 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.
Once reduction was established, fixation was accomplished using an lshaped plate at the zygomaticomaxillary buttress and. A flat malar arch is best assessed from behind the patients head. Closed treatment for zygoma, zygomatic complex fracture. Classification and treatment of zygomatic fractures. We now carry out a linear elastic stress analysis of the cracked body, which will allow us to formulate critical conditions for the 16 growth of flaws more precisely. Complex fractures may include the cheekbone and part of the orbit of the eye. Zygomatic complex fractures at the university college hospital, ibadan, nigeria. Modification of the hemicoronal approach to treat fractures. In the united states, zygomatic fractures are the second most common fracture of the facial bones following nasal bone fractures. A modified miniplate for use in malar complex fractures. Evaluation of zygomatic complex fractures based on three.
The advent of biodegradable bone plates and screws system has almost solved the problems of stress shielding, removal surgery and corrosion when plates are leftinsitu. Fracture of the lateral orbital rim, zygomatic arch, inferior orbital rim and anterior and posterior maxillary sinus walls are identified. Zygomaticomaxillary complex fracture pubmed central pmc. Zygomatic complex fracture treatment at edens dental youtube. The malar complex is also commonly fractured in isolation by a blow to that area. Complicated zygomaticomaxillary complex fracture, known as one of the most challenging facial bone fractures.
Rice division of applied sciences, harvard university, cambridge ma 028 readers comments on an earlier draft, prepared in consultation with j. A new classification of zygomatic fracture featuring zygomaticofrontal suture. Ppt zygomatic complex fractures powerpoint presentation. These will stay in place unless they cause problems, in which case a second operation will be required to remove them. The fractures through the lateral buttress and the inferior orbital rim are commonly. Consideration 1 indications second most common mid face fracture nasal fracture. Fracture of the zygomatic complex is amongst the most frequent in maxillofacial trauma, due to its prominence which predisposes.
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. The aim of this paper is to evaluate zygomatic complex fractures based on three point fixation technique using additive manufacturing process. Fractures that involve the zygoma often occur at these four suture sites, leading to a tetrapod fracture pattern, known as a zygomatic complex fracture zmc. Zygomatic fractures american academy of ophthalmology. The precise location of cracks are unpredictable the load level are more precisely estimated. Objective evaluate the 1year treatment outcome of zygomatic complex fractures with surgical or nonsurgical intervention. Development of fixation devices has progressed greatly over the past twenty years. Reduction was achieved using a carrollgirard screw fig 2. Surgical methods of zygomaticomaxillary complex fracture. Linear elastic fracture mechanics many structural failure modes are discovered by disasters examples. 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. The strong central part of the bone usually remains intact and the force is transmitted to the three. It is possible that you will heal totally normally or with a change in your cheek bone that is perfectly acceptable. Therefore, a patient with a zygomatic fracture and diplopia should be classified as having a orbitozygomatic fracture.
Minimization of zygomatic complex fracture treatment. Zygomatic complex fractures and its management acta scientific. Surgical management of zygomatic complex fractures in a. Therefore for cosmetic and functional reasons it is imperative to diagnoseand treat zygomatic fractures adequately. Prediction of crack growth can be based on an energy balance. We help you select the appropriate treatment of zygoma, zygomatic complex fracture. A prospective short clinical study ramesh candamourty 1, vinod narayanan 2, mf baig 2, mr muthusekar 2, manoj kumar jain 3, ramesh m. Prior to definitive fixation of this severely comminuted fracture of the zygomatic complex, congruency and alignment of the fracture borders must be inspected again to assure correct threedimensional repositioning of the frontozygomatic suture, lateral orbital rim fragments, and the zygomaticomaxillary buttress. The preceding analysis considered fracture from an energy standpoint. The high incidence of zygomatic complex fracture relates to its. Synonyms tripod fracture, tetrapod fracture, trimalar fracture, zygomatic complex fracture, malar complex fracture, maxillary complex fracture, orbitozygomaticomaxillary fracture. Injury mechanism and a guide to treatment hisao ogata, yoshiaki sakamoto and kazuo kishi department of plastic and reconstructive surgery, keio university school of medicine, shinjukuward, tokyo, japan. Diagnosis and management of common maxillofacial injuries.
The face symmetry has prominent role in the human body after injuries and accident. Analysis of outcome of zygomatic fracture management. Management of zygomatic fractures pocket dentistry. Reconstructive procedures protocols general considerations. Postoperative radiographs of a complex zygomatic fracture.
Zygomatic complex fracture gilles temporal technique. The zygomatic region is important factor in the injuries face. Definitions zygoma is a very crucial component which maintains facial contour. Management of tripod fractures zygomaticomaxillary. Other possible functional deficits that may occur include limitation of mouth opening and lower eye lid retraction. Zygomatic complex fractures in a suburban nigerian population. Patients treated for isolated zygomatic fractures at the keio univeristy hospital between 2004 and 2011 were recruited for this study. Apr 04, 2017 this is a treatment of zygomatic complex fracture treatment at edens dental and maxillofacial hospital,parvathipuram,nagercoil by prof. The fracture will be realigned and then fixed together using titanium plate and screws. Zygomaticomaxillary complex fracture radiology reference. To evaluate the advantages and efficacy of two point mini plate fixation for the zygomatic complex fractures using lateral eye brow and infra orbital approaches for fixing the fronto zygomatic fracture and infra orbital fracture. Considering high incidence of zygomatic complex fractures and its high morbidity complications, this study had been planned to find out the important clinical and epidemiological features in patients with zygomatic complex fracture.
The aim of this study is to evaluate the clinical and radiological features of zygoma fractures and to analyze the functional and esthetic outcome of zygoma fracture. Surgical navigation improves reductions accuracy of. Apr 27, 2014 the zygoma may be separated from its 4 atriculations. Fractures of the zygomatic complex and arch pocket. Full text full text is available as a scanned copy of the original print version. The aim of this research was to analyze the surgical approaches and methods of rigid fixation used to treat zygomatic complex zc fractures over a 10year period. Ultrasonography vs computed tomography in imaging of zygomatic complex fractures. A study on assessing the etiology and different treatment. Assessment of zygomaticoorbital complex fractures using ultrasonography article in british journal of oral and maxillofacial surgery 385. In zygomaticomaxillary complex zmc fracture many incisions lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral.
This technique is contraindicated if there is a fracture. Ultrasonography vs computed tomography in imaging of. Moreover the importance of zygomatic complex in facial skeleton lies inprotecting globe of eye and absorbing and redistributing masticatory andexternal load. This is most commonly seen after assault, but any blow to the cheek may give rise to a fracture. To fully understand this failure mechanism, the total. Treatment of zygomatic complex fractures using two point. Pdf zygomatic complex fractures in a suburban nigerian. Exploration of the orbital floor is indicated only in cases of preoperative diplopia. Clinical and epidemiological presentation of patients with. Zygomatic complex fracture is the second most common fracture of facial region just behind isolated nasal fractures. Zygomaticomaxillary complex fractures by dara liotta, md.
Zygomaticomaxillary complex fracture aka tripod fracture the red arrow indicates fracture of the frontal process of the zygoma, the green arrow indicates fracture of the zygomatic arch, the blue arrow indicates fracture of the zygomatic process of the maxilla or the zygomaticomaxillary suture, and the purple arrow indicates fracture of the nasomaxillary suture. 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. Due to the prominent position of the zygomatic region, the zygomaticomaxillary complex zmc fracture is one of the most common facial frac ture. A simple zygomatic fracture is a hairline break in the zygoma, or cheekbone. Zygomatic complex fractures, facial fracture, etiolo gy, surgical approach. A 3d axial ct scan revealed a comminuted fracture of the zygomatic bone.
I have a zygomatic arch fracture with no deformities. Analysis of fracture and fatigue using a simplified stress. Fractures of the zygomatic complex are among the most frequent in maxillofacial trauma. Closed treatment of fractures of the zygomatic complex refers to the management of fractures of the zygomatic complex where, either prior to or following the reduction of the zygoma, the patient does not have a significant orbital defect. Get a printable copy pdf file of the complete article 2. 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. Fractures of the body of the zygomatic complex without rotation in theanteroposterior direction z axistype 4. Fractures of zygomatic complex and orbit maxfac tutorial. This patient sustained a road traffic accident and got the left side of the face smashed up. Dec 03, 2018 the zygomatic bone occupies a prominent and important position in the facial skeleton. Three point fixation is superior to two point fixation. Accurate reduction is the key to successful treatment of bone fractures. Right zygomaticomaxillary complex fracture with disruption of the lateral orbital wall, orbital floor, zygomatic arch and maxillary sinus. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques two point and three point in patients with zygomatic complex fracture.
In the present study, twelve adult patients of zygomatic complex fractures. Treatment modalities in zygomatic complex fractures. Oct 30, 2010 kharkar vr, rudagi bm, halli r, kini y 2010 comparison of modified lateral orbitotomy approach and modified hemicoronal approach in the treatment of unstable malunions of zygomatic complex fractures. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. 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.
Jun 24, 2016 the most common zygomaticomaxillary complex zmc fracture pattern involves fracture of the frontozygomatic suture lateral orbital rim, the zygomatic arch, the lateral buttress zygomaticomaxillary buttress, and the inferior orbital rim cummings 2005. The treatment of a zygomatic fracture is possible by the described technique. Fractures of the body of the zygomatic complex with rotation in theanteroposterior direction4a. It is applicable to any materials as long as the material is elastic except in a vanishingly small region at the crack tip assumption of small scale yielding, brittle or quasibrittle fracture, stable or unstable crack growth. The zygomaticomaxillary complex is an important functional and esthetic landmark of midface, and it provides prominence to the cheek. They are the second most common facial bone fracture after nasal bone fractures pathology. Zygomatic complex fracture tripod fracture iowa head and.
An analysis of this type falls within the field of linear elastic fracture mechanics lefm. Linear elastic fracture mechanics lefm is the basic theory of fracture, that deals with sharp cracks in elastic bodies. In one case, the patient sustained zygomaticomaxillary complex fracture. Untreated fractures may cause a cosmetic deformity flattening of the cheek or limited mandibular movement caused by the depressed zygoma impinging on the coronoid process of the mandible. Oral surg oral med oral pathol oral radiol endod 1094. Failure involving instability can be particularly surprising fatigue is a failure mode that can be characterized experimentally without the need for fracture mechanics.