Zygomatic arch fracture

Background

• Must distinguish zygomatic arch fx from Zygomaticomaxillary (Tripod) Fracture
  • Tripod fx = fx of zygomatic arch, lat and inf orbital rims, lat wall of maxillary sinus

Diagnosis

• 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

• Ears
  • Auricular hematoma
• Nose
  • Nasal fracture
  • Nasal septal hematoma
• Oral
  • Dental trauma
  • Lip laceration
  • Tongue laceration
• Other face
  • Le Fort fractures
  • Mandible fracture
• Zygomatic arch fracture
• Zygomaticomaxillary (tripod) fracture
• Related
  • Head trauma (main)
    • Skull fracture
    • Skull fracture (peds)
    • Basilar skull fracture
  • Orbital trauma
    • Eyelid laceration
  • Scalp laceration

Management

• Facial CT

Disposition

Discharge

See Also

Maxillofacial Trauma

References

Tintinalli's