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Zygomaticomaxillary ( ZMC ) Fracture
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Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Dec 31, 2015

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Madison Cobb
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Page 1: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Zygomaticomaxillary( ZMC )Fracture

Page 2: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Anatomy• Similar to a 4- sided pyramid• It has Temporal, Orbital,

Maxillary & Frontal processes• The Zygoma is the origin to

major portion of the masseter muscle

• The malar bone represents a strong bone on fragile supports, and it is for this reason that, though the body of the bone is rarely broken, the four processes—frontal, orbital, maxillary, and zygomatic—are frequent sites of fracture.

Page 3: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Anatomy

• Usually 4 fx lines exist:• Anteromedial in the floor of

the orbit• Superolateral in the lateral

orbital wall• Inferior to the maxillary

buttress• in the zygomatic arch

Page 4: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Diagnosis

Clinical• Perform a neurologic & ophthalmic

evaluation first• Signs & symptoms:• Periorbital Ecchymosis and Edema• Flattening of the Malar Prominence• Ecchymosis of the Maxillary Buccal Sulcus• Deformity at the Zygomatic Buttress of the

Maxilla• Deformity of the Orbital Margin• Trismus• Abnormal Nerve Sensibility• Subconjunctival Ecchymoses• Displacement of the Palpebral Fissure.• Diplopia• Enophthalmos

Radiographic

Page 5: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Flattening of the Malar Prominence.

Page 6: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Trismus

Page 7: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Displacement of the Palpebral Fissure & Unequal pupillary Level

Page 8: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Abnormal Nerve Sensibility.

Page 9: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Enophthalmousaccentuationof the sulcus of the upper lidnarrowing of the palpebralFissurpseudoptosis of the upper lid

Page 10: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Radiologic Assessment

Axial & coronal CT is the method of choice

Page 11: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Radiologic Assessment(3D Reconstruction)

Page 12: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Complexities in TX of ZMC FX

• Rotation of the fractured ZMC

Page 13: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Complexities in TX of ZMC FX

• Concomitant undiagnosed NOE FX

Page 14: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Complexities in TX of ZMC FX

• Lateral displacement of Malar bone

Page 15: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

SURGICAL APPROACHES TOZYGOMATICOMAXILLARY

COMPLEX FRACTURES

Page 16: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Maxillary Vestibular Approach

Page 17: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Supraorbital Eyebrow Approach

Page 18: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Upper Eyelid Approach

Page 19: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Lower Eyelid Approaches

Page 20: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Transconjunctival Approach

Page 21: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Bicoronal / Coronal Approach

Page 22: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Gillies Temporal Approach

Page 23: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Buccal Sulcus Approach( Keen Technique )

Page 24: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Elevation From Eyebrow Approach

Page 25: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Percutaneous Approach

Page 26: Zygomaticomaxillary ( ZMC ) Fracture. Anatomy Similar to a 4- sided pyramid It has Temporal, Orbital, Maxillary & Frontal processes The Zygoma is the.

Percutaneous Approach(Carroll- Girrard Bone Screw)