Abstract
Zygoma fractures are common facial fractures. Anatomical fracture patterns and the nuances of clinical presentations are discussed. Points to note on the CT imaging are illustrated. Treatment goals focus on reduction to reestablish normal orbital volume and adequate fixation, preferably three-point. Surgical approaches to zygoma and zygomatic arch fractures are examined. Finally complications and tips on prevention are detailed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Bibliography
Alqurainy IA, Stassen LF, Dutton GN, et al. The characteristics of midfacial fractures and the association with ocular surgery: a prospective study. J Oral Maxillofac Surg. 1991;29:302.
Barclay TL. Diplopia in association with fractures of the zygomatic bone. Br J Plast Surg. 1958;11:147.
Barclay TL. Four hundred malar-zygomatic fractures. Transactions of the International Society of Plastic Surgeons, Second Congress. Edinburgh: E & S Livingstone; 1960. p. 259.
Brown MS, Ky W, Lisman RD. Concomitant ocular injuries with orbital fractures. J Craniomaxillofac Trauma. 1999;5:41.
Chen CT. Endoscopic zygomatic fracture repair. Oper Tech Plast Reconstr Surg. 1998;5:282.
Chen CT, Chen YR. Application of the endoscope in orbital fractures. Semin Plast Surg. 2002;16:241.
Dal Santo F, Ellis E, Throckmorton GS. The effects of zygomatic complex fracture on masseteric muscle force. J Oral Maxillofac Surg. 1992;50:791.
Dolynchuk V, Tadjalle H, Manson P. Orbital volumetric analysis: clinical application in orbitozygomatic injuries. J Craniomaxillofac Trauma. 1996;2:56.
Funk GE, Stanley RB, Becker TS. Reversible visual loss due to impacted lateral wall fractures. Head Neck Surg. 1987;113:87.
Furst IM, Austin P, Phardah M, Mahoney J. The use of computed tomography to define zygomatic complex position. J Oral Maxillofac Surg. 2001;59:647.
Girotto J, Gamble B, Robertson B, et al. Blindness following reduction of facial fractures. Plast Reconstr Surg. 1998;102:1821.
Glassman RD, Manson PN, Petty P, et al. Techniques for improved visibility and lid protection in orbital explorations. J Craniofac Surg. 1990;1:69.
Gruss JS. Naso-ethmoid-orbital fractures: classification and role of primary bone grafting. Plast Reconstr Surg. 1985;75:303.
Gruss JS, Hurwitz JJ. Isolated blow in fracture of the lateral orbit causing globe rupture. Ophthal Plast Reconstr Surg. 1990;6:221.
Hakelius L, Ponten B. Results of immediate and delayed surgical treatment of facial fractures with diplopia. J Maxillofac Surg. 1973;1:150.
Hollier L, Thornton J, Pazmino P, Stal S. The management of orbitozygomatic fractures. Plast Reconstr Surg. 2003;111:2386.
Holt GR, Holt SE. Incidence of ocular injuries in facial fractures: an analysis of 727 cases. Otolaryngol Head Neck Surg. 1983;91:276.
Hwang K, Suh MS, Chung IH. Cutaneous distribution of the infraorbital nerve. J Craniofac Surg. 2004;15:3.
Jackson IT. Classification and treatment of orbitozygomatic and orbitoethmoid fractures: the place of the bone grafting and plate fixation. Clin Plast Surg. 1989;16:77.
Kasrai L, Hearn T, Gur F, Forrest C. A biochemical analysis of the orbital zygomatic complex in human cadavers: examination of load sharing and failure patterns following fixation with titanium and bioresorbable systems. J Craniofac Surg. 1999;10:237.
Kawamoto Jr HK. Late posttraumatic enophthalmos: a correctable deformity? Plast Reconstr Surg. 1982;69:423.
Kelly K, Manson PN, Vander Kolk C, Markowitz B. Sequencing treatment in midface fractures. J Craniofac Surg. 1990;1:168.
Ketchum LD, Ferris B, Masters FW. Blindness in midface fractures without direct injury to the globe. Plast Reconstr Surg. 1976;55:187.
Knight JS, North JF. The classification of malar fractures: an analysis of displacement as a guide to treatment. Br J Plast Surg. 1961;13:315.
Kobayashi S, Sakai Y, Yamada A, Ohmori K. Approaching the zygoma with an endoscope. J Craniofac Surg. 1998;6:519.
Lacy MF, Popisil OA. Lower blepharoplasty post-orbicularis approach to the orbit-a prospective study. Br J Oral Maxillofac Surg. 1987;25:398.
Lederman IR. Loss of vision associated with surgical treatment of zygomatic-orbital floor fracture. Plast Reconstr Surg. 1981;68:94.
Lyon DB, Newman SA. Evidence of direct damage to extraocular muscles as a cause of diplopia following orbital trauma. Ophthal Plast Reconstr Surg. 1989;5:81.
MacKinnon CA, David DJ, Cooter RD. Blindness and severe visual impairment in facial fractures: an 11 year review. Br J Plast Surg. 2002;55:1.
Manson PN. Computed tomography use in repair of orbitozygomatic fractures. Arch Facial Plast Surg. 1999;1:25.
Manson P. Complications of facial fractures. In: Goldwyn R, Cohen S, editors. Complications in plastic surgery. New York: Lippincott-Raven; 2001a. p. 489–513.
Manson PN. Facial fractures. In: Goldwyn R, Cohen S, editors. The unfavorable result in plastic surgery-avoidance and treatment. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001b. p. 489–520.
Manson P. Facial fractures. In: Mathes S, editor. Plastic surgery, vol. 3. Philadelphia: WB Saunders; 2006. p. 77–380.
Manson PN, Iliff N. Surgical anatomy of the orbit. In: Marsh J, editor. Current therapy in plastic and reconstructive surgery. Philadelphia: BC Decker; 1989. p. 117.
Manson PN, Grivas A, Rosenbaum A, et al. Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg. 1986a;77:203.
Manson PN, Clifford CM, Su CT, et al. Mechanisms of global support and post-traumatic enophthalmos: I. The anatomy of the ligament sling and its relation to intramuscular cone orbital fat. Plast Reconstr Surg. 1986b;77:193.
Manson P, Markowitz B, Mirvis S, et al. Toward CT-based facial fracture treatment. Plast Reconstr Surg. 1990;85:202.
Manson P, Clark N, Robertson B, Crawley W. Comprehensive management of pan-facial fractures. J Craniomaxillofac Trauma. 1995;1:43.
Millman AL, Lubkin V, Gersten M. Three-dimensional reconstruction of the orbit from CT scans and volumetric analysis of orbital fractures: its role in the evaluation of enophthalmos (editorial). Adv Ophthalmic Plast Reconstr Surg. 1987;6:265.
O’Hara D, Delvecchio D, Bartlett S, Whitaker L. The role of microfixation in malar fractures: a quantitative biophysical study. Plast Reconstr Surg. 1996;97:345.
Perino KE, Zide ME, Kinnebrew MC. Late treatment of malunited malar fractures. J Oral Maxillofac Surg. 1980;42:20.
Petro J, Tooze FM, Bales CR, Baker CR. Ocular injuries associated with periorbital fractures. J Trauma. 1970;19:730.
Phillips J, Gruss J, Wells M. Periorbital suspension of lower eyelid and cheek following subciliary exposures of facial fractures. Plast Reconstr Surg. 1991;88:145.
Pospisil OA, Fernando TD. Review of the lower blepharoplasty incision as a surgical approach to the zygomatic orbital fractures. Br J Oral Maxillofac Surg. 1984;22:261.
Rinehart G, Marsh J, Hemmer K. Internal fixation of malar fractures: an experimental biophysical study. Plast Reconstr Surg. 1989;84:21.
Rohner D, Tay A, Meng CW, et al. The sphenozygomatic suture as a key site for osteosynthesis of the orbitozygomatic complex in panfacial fractures: a biochemical study in cadavers based on clinical practice. Plast Reconstr Surg. 2002;110:1463.
Rohrich RJ, Watumull D. Comparison of rigid plate versus wire fixation in the management of zygomatic fractures: a long-term follow-up clinical study. Plast Reconstr Surg. 1995;96:570.
Rohrick R, Hollier LH, Watumull D. Optimizing the treatment of orbitozygomatic fractures. Clin Plast Surg. 1992;19:149.
Roncevi R, Stajcic Z. Surgical treatment of post-traumatic enophthalmos: a study of 72 patients. Ann Plast Surg. 1994;32:288.
Schmitz JP, Hollinger JO. The critical size defect as an experimental model for craniomandibulofacial nonunions. Clin Orthop. 1986;205:299.
Sires BS, Stanley RB, Levine LM. Oculocardiac reflex caused by orbital floor fracture: an indication for urgent repair. Arch Ophthalmol. 1998;116:955.
Stanley Jr RB. Use of intraoperative computed tomography during repair of orbitozygomatic fractures. Arch Facial Plast Surg. 1999;12:523.
Stanley RB, Sis BS, Frank GF, Nerd JA. Management of the displaced lateral orbital wall fractures associated with visual and ocular motility disturbances. Plast Reconstr Surg. 1998;102:972.
Sungeil P, Lindquist C. Paresthesia of the infraorbital nerve following fracture of the zygomatic complex. Int J Oral Maxillofac Surg. 1987;16:363.
Uriens JPM, Vanderglas HW, Bosman F, et al. Infraorbital nerve function following treatment of orbitozygomatic complete fractures: a multitest approach. Int J Oral Maxillofac Surg. 1998;27:27.
Wolfe SA, Davidson J. Avoidance of lower lid contraction in surgical approaches to the lower orbit. Oper Tech Plast Reconstr Surg. 1998;5:201.
Yab K, Tijima S, Imai K. Clinical application of a solid three-dimensional model for orbital wall fractures. J Craniomaxillofac Surg. 1993;21:275.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Kelly, K.J., Gill, R. (2015). Zygoma Fractures. In: Taub, P., Patel, P., Buchman, S., Cohen, M. (eds) Ferraro's Fundamentals of Maxillofacial Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8341-0_16
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8341-0_16
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8340-3
Online ISBN: 978-1-4614-8341-0
eBook Packages: MedicineMedicine (R0)