Does tripod fracture need surgery

Fractures with displacement require surgery consisting of fracture reduction with miniplates, microplates and screws. Gillie’s approach is used for depressed zygomatic fractures. The prognosis of tripod fractures is generally good.

What are the surgical approaches commonly used in treatment of ZMC fractures?

Common surgical approaches to the ZMC buttresses include sublabial, lateral orbit, lower eyelid, and scalp incisions. These incisions should be used in a hierarchical fashion starting with the sublabial incision.

How do you fix a broken ZMC?

The most common indication for surgery in ZMC fractures is displacement and rotation, and most displaced ZMC fractures should be treated surgically. If reduction is not performed properly, facial asymmetry will be prominent, as the result of lowering the malar prominent point [2].

What is Gillies approach?

Temporal (Gillies) approach – Skin incision The Gillies technique describes a temporal incision (2 cm in length), made 2.5 cm superior and anterior to the helix, within the hairline. A temporal incision is made. Care is taken to avoid the superficial temporal artery.

What is a ZMC fracture?

The term ZMC fracture describes a spectrum of injuries that includes nondisplaced fractures, fractures displaced at an isolated buttress, and severely comminuted fractures with bone loss. Information about the degree and severity of the overall injury can be extrapolated from the location of the fractures.

How do you treat a ZMC fracture?

Most zygomatic complex fractures can be treated solely by an intraoral approach and rigid fixation at the zygomaticomaxillary buttress. Further exposure of the zygomaticofrontal junction or inferior orbital rim is necessary for severely displaced fractures, which require additional fixation.

Where is a tripod fracture located?

They are the second most common facial bone fracture after nasal bone injuries. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma.

What happens if you break your zygomatic bone?

Fractures of the ZMC or zygomatic arch can often lead to unsightly malar depression, which should be corrected to restore a normal facial contour. ZMC fractures can also cause significant functional issues, including trismus, enophthalmos and/or diplopia, and paresthesias of the infraorbital nerve.

What is a maxillary fracture?

A maxilla fracture happens when the maxilla becomes cracked or broken. This often happens due to injuries to the face, such as from falling, a car accident, getting punched, or running into an object. These injuries can be significant.

What is a coronal incision?

The coronal or bi-temporal approach is used to expose the anterior cranial vault, the forehead, and the upper and middle regions of the facial skeleton. The extent and position of the incision, as well as the layer of dissection, depends on the particular surgical procedure and the anatomic area of interest.

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What does the zygomatic bone articulate with?

The zygomatic bone articulates with the sphenoid bone, maxilla, frontal bone, and temporal bone to form the lateral wall of the floor of the orbit, part of the temporal and infratemporal fossa, and the prominence of the cheek.

Where is the zygomatic arch?

zygomatic arch, bridge of bone extending from the temporal bone at the side of the head around to the maxilla (upper jawbone) in front and including the zygomatic (cheek) bone as a major portion.

What nerves are frequently involved in ZMC fractures?

Paresthesia of the face is a common sequela of a ZMC fracture given its proximity to sensory nerves such as the infraorbital nerve, the zygomaticofacial nerve, and the zygomaticotemporal nerve (all branches of cranial nerve V2).

What is Enophthalmus?

Enophthalmos is posterior displacement of the eye. The anterior projection of the eye is most commonly measured relative to the outer edge of the orbit, the orbital rim, but may also be assessed relative to the frontal and maxillary prominences, or the contralateral eye.

What is a linear fracture?

In a linear fracture, there is a break in the bone, but it does not move the bone. These patients may be observed in the hospital for a brief amount of time, and can usually resume normal activities in a few days.

What is Zygomaticomaxillary fracture?

Zygomaticomaxillary Complex (ZMC) fractures result from blunt trauma to the periorbital area (viz. malar eminence). ZMC fractures are also referred to as tripod, trimalar, tetrapod, quadripod, or malar fractures.

Is a comminuted fracture displaced?

Displaced and non-displaced fractures refer to the alignment of the fractured bone. In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture.

What is Zygomaticomaxillary complex fracture?

A zygomatic complex fracture is a fracture that involves the zygoma and its surrounding bones. The typical lines of a zygomatic complex fracture are: A fracture emanating from the inferior orbital fissure superiorly along the sphenozygomatic suture to the frontozygomatic suture where it crosses the lateral orbital rim.

What bones are involved in a tripod fracture?

• zygomatic arch.
• inferior orbital rim, and anterior and posterior maxillary sinus walls.
• lateral orbital rim.

What is a tripod fracture and name the bones that is involved?

tri·pod frac·ture. a facial fracture involving the three supports of the malar prominence, the arch of the zygomatic bone, the zygomatic process of the frontal bone, and the zygomatic process of the maxillary bone.

What is a displaced tripod fracture?

A tripod fracture is a facial fracture that involves the zygoma, which is displaced. It may involve the arch and the orbit.

What is the Frontozygomatic suture?

Anatomical terminology. The zygomaticofrontal suture (or frontozygomatic suture) is the cranial suture between the zygomatic bone and the frontal bone. The suture can be palpated just lateral to the eye.

How do you reduce zygomatic bone?

Cheekbone reduction surgery or zygoma reduction surgery is a cosmetic surgical procedure to reduce the width of upper face essentially the cheekbone in order to make the face smaller, oval and more feminine. This surgical procedure is commonly done for patient who has a wide face due to large or prominent cheek bones.

How do I know if my zygomatic bone is broken?

1. Flatness of the cheek.
2. Altered sensation underneath the eye on the affected side.
3. Problems with eyesight.
4. Pain with jaw movement.

What is the treatment for maxillary fracture?

Maxillary fractures are treated by reduc- tion and immobilization. Establishment of preinjury occlusion and midface buttress alignment provides the foundation for this treatment. The goals of treatment of LeFort fractures are to reestablish preinjury occlusion with normal height and projection of the face.

How long does it take for a fractured maxilla to heal?

Although the plates and screws hold your jaw in place it still takes about six weeks for your jaw to heal completely. During this time you need to eat soft food only. Your surgeon will give you advice on this. You must be careful to avoid another injury as it may push your jaw out of position again.

What are the causes of maxillary fracture?

Maxillary fractures often result from high-energy blunt force injury to the facial skeleton. Typical mechanisms of trauma include motor vehicle accidents, altercations, and falls.

How long does it take for a zygomatic bone to heal?

Even if the position of the fractured bone has been held with plates and screws it still takes about six weeks for your cheekbone to heal completely. During this time you need to be careful to avoid an injury to this side of your face, since it may well push the cheekbone back out of position again.

How do I know if I've fractured my cheekbone?

Blurred or double vision, or problems moving your eyes. Trouble swallowing or breathing. Displaced jaw or nose. Upper and lower jaw that don’t meet properly, or pain when you move your jaw.

What are the symptoms of a broken cheekbone?

• Pain, tenderness, and swelling.
• A flat appearance to the face.
• Vision problems.
• Blood in the side of the eye (on the affected side)
• Jaw pain, specifically when jaw is moved.
• Numbness under the eye of the injured side.

What is a Bicoronal flap?

The bicoronal flap was first described by Hartley and Kenyon (neurosurgeons) to gain access to the anterior cranium in 1907. It extension as an access flap to the upper and lateral aspect of the face was pioneered by Tessier (1971). Esthetically, it is pleasing as the surgical scar is hidden within the hair.