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Case: Zygomaticomaxillary Complex Fracture

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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.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Trauma

Paranasal sinuses

Orbit

Neuroradiology

Maxillofacial

Head and Neck

Emergency

CT

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