Case 5 - Tripod Fracture
HIDEInteractive Transcript
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Well, again, this is the case that keeps on giving.
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Let's look at this case again from the standpoint
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of the Zygomaticomaxillary complex fractures.
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So as we look at the lateral orbit, we see that there is the
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comminuted fracture and this is the junction
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of the zygoma with that frontal bone.
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We can see that there's the fracture as it communicates with
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the maxillary antrum and the maxillary
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bone. So that is fractured as well.
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We see that the zygomatic arch is comminuted and fractured. And
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then the more posterior portion here, as it attaches to the
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temporal bone and sphenoid portion
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of the greater wing of the sphenoid,
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actually, the greater wing of the sphenoid more up here,
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but the basisphenoid is fractured as well.
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And looking at this in a coronal plane, we see that this is the
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portion of the bone that is effectively disarticulated here,
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communicating with the frontal bone,
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the lateral orbit to the maxillary bone.
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And then we had the arch fracture seen here.
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Let's look at this from the three dimensional
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reconstruction on the right side,
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and you can see this whole segment
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has been fractured. Here's
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the zygoma and all of its communications being disrupted,
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extending to the orbital floor.
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And this bone needs to be realigned as well as pexied,
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if you will,
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to the structural integrity of the rest of the facial bones.
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So the tri malar tripod zygomaticomaxillary complex fracture.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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