Zygomatic arch fracture

Background

• Must distinguish zygomatic arch fx from zygomaticomaxillary (tripod) fx
  • 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

Management

• Facial CT

Disposition

• Isolated zygomatic arch fx: discharge
• Tripod fx w/ loss of vision or displacement: admit for IV abx and sx

See Also

Maxillofacial Trauma