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0:01

Well, again, this is the case that keeps on giving.

0:03

Let's look at this case again from the standpoint

0:07

of the Zygomaticomaxillary complex fractures.

0:12

So as we look at the lateral orbit, we see that there is the

0:17

comminuted fracture and this is the junction

0:20

of the zygoma with that frontal bone.

0:24

We can see that there's the fracture as it communicates with

0:28

the maxillary antrum and the maxillary

0:32

bone. So that is fractured as well.

0:35

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

0:46

temporal bone and sphenoid portion

0:48

of the greater wing of the sphenoid,

0:51

actually, the greater wing of the sphenoid more up here,

0:53

but the basisphenoid is fractured as well.

0:57

And looking at this in a coronal plane, we see that this is the

1:03

portion of the bone that is effectively disarticulated here,

1:09

communicating with the frontal bone,

1:10

the lateral orbit to the maxillary bone.

1:15

And then we had the arch fracture seen here.

1:19

Let's look at this from the three dimensional

1:23

reconstruction on the right side,

1:26

and you can see this whole segment

1:29

has been fractured. Here's

1:31

the zygoma and all of its communications being disrupted,

1:38

extending to the orbital floor.

1:40

And this bone needs to be realigned as well as pexied,

1:47

if you will,

1:48

to the structural integrity of the rest of the facial bones.

1:52

So the tri malar tripod zygomaticomaxillary complex fracture.

Case 5 - Tripod Fracture

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0:01

Well, again, this is the case that keeps on giving.

0:03

Let's look at this case again from the standpoint

0:07

of the Zygomaticomaxillary complex fractures.

0:12

So as we look at the lateral orbit, we see that there is the

0:17

comminuted fracture and this is the junction

0:20

of the zygoma with that frontal bone.

0:24

We can see that there's the fracture as it communicates with

0:28

the maxillary antrum and the maxillary

0:32

bone. So that is fractured as well.

0:35

We see that the zygomatic arch is comminuted and fractured. And

0:41

then the more posterior portion here, as it attaches to the

0:46

temporal bone and sphenoid portion

0:48

of the greater wing of the sphenoid,

0:51

actually, the greater wing of the sphenoid more up here,

0:53

but the basisphenoid is fractured as well.

0:57

And looking at this in a coronal plane, we see that this is the

1:03

portion of the bone that is effectively disarticulated here,

1:09

communicating with the frontal bone,

1:10

the lateral orbit to the maxillary bone.

1:15

And then we had the arch fracture seen here.

1:19

Let's look at this from the three dimensional

1:23

reconstruction on the right side,

1:26

and you can see this whole segment

1:29

has been fractured. Here's

1:31

the zygoma and all of its communications being disrupted,

1:38

extending to the orbital floor.

1:40

And this bone needs to be realigned as well as pexied,

1:47

if you will,

1:48

to the structural integrity of the rest of the facial bones.

1:52

So the tri malar tripod zygomaticomaxillary complex fracture.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Head and Neck

Emergency

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