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Zygomatic arch fracture
From WikEM
Contents
Background
- Must distinguish zygomatic arch fracture from Zygomaticomaxillary (Tripod) Fracture
- Tripod fracture = fracture of zygomatic arch, lat and inf orbital rims, lat wall of maxillary sinus
Evaluation
- Exam
- Flattening of malar eminence
- Eye findings
- Eye may appear to tilt (pulling of lateral canthus)
- Subconjunctival hemorrhage
- Trismus (masseter spasm or impingement of temporalis muscle or coronoid process)
- Palpate posterior surface of arch for tenderness/loss of space compared to other side
Differential Diagnosis
Maxillofacial Trauma
- Le Fort fractures
- Skull fracture (peds)
- Auricular hematoma
- Nasal fracture
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Dental trauma
- Mandible fracture
Orbital trauma
Acute
- Ruptured Globe^
- Corneal Abrasion
- Ocular foreign body
- Conjunctival laceration
- Caustic Keratoconjunctivitis^^
- Subconjunctival hemorrhage
- Traumatic iritis
- Traumatic hyphema
- Retinal detachment
- Retrobulbar hemorrhage/hematoma
- Traumatic mydriasis
- Orbital fracture
- Frontal sinus fracture
- Naso-ethmoid fracture
- Inferior orbial wall fracture
- Medial orbital wall fracture
Subacute/Delayed
Management
- Facial CT
Disposition
Discharge
