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Zygomaticomaxillary Complex Fracture
Blair A. Winegar, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Zygomaticomaxillary complex (ZMC) fracture
            • Synonyms

              • Trimalar fracture; tripod fracture; displaced ZMC fracture = quadripod or quadramalar fracture
                • Sometimes called trimalar fracture because 3 fractures are seen on radiographs
                  • Lateral orbital rim (frontozygomatic suture)
                  • Separation of maxilla & zygoma (zygomaticomaxillary suture)
                  • Zygomatic arch (zygomaticotemporal suture)
              • ZMC fracture terminology most universally accepted
                • Trimalar or tripod fracture terminology fails to acknowledge fracture of lateral orbital wall (zygomaticosphenoid suture)
            • Definitions

              • Fracture complex with fracture lines involving zygomatic arch, lateral orbital wall, anterior & lateral walls of maxillary sinus, & orbital floor

            IMAGING

            • General Features

              • CT Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                Selected References

                                1. Winegar BA et al: Spectrum of critical imaging findings in complex facial skeletal trauma. Radiographics. 33(1):3-19, 2013
                                2. Buchanan EP et al: Zygomaticomaxillary complex fractures and their association with naso-orbito-ethmoid fractures: a 5-year review. Plast Reconstr Surg. 130(6):1296-304, 2012
                                3. Fraioli RE et al: Facial fractures: beyond Le Fort. Otolaryngol Clin North Am. 41(1):51-76, vi, 2008
                                4. Hopper RA et al: Diagnosis of midface fractures with CT: what the surgeon needs to know. Radiographics. 26(3):783-93, 2006
                                5. Linnau KF et al: Imaging of high-energy midfacial trauma: what the surgeon needs to know. Eur J Radiol. 48(1):17-32, 2003
                                6. Salvolini U: Traumatic injuries: imaging of facial injuries. Eur Radiol. 12(6):1253-61, 2002
                                7. Sun JK et al: Imaging of facial trauma. Neuroimaging Clin N Am. 12(2):295-309, 2002
                                8. Rhea JT et al: Helical CT and three-dimensional CT of facial and orbital injury. Radiol Clin North Am. 37(3):489-513, 1999
                                9. Daffner RH: Imaging of facial trauma. Curr Probl Diagn Radiol. 26(4):153-84, 1997
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Zygomaticomaxillary complex (ZMC) fracture
                                          • Synonyms

                                            • Trimalar fracture; tripod fracture; displaced ZMC fracture = quadripod or quadramalar fracture
                                              • Sometimes called trimalar fracture because 3 fractures are seen on radiographs
                                                • Lateral orbital rim (frontozygomatic suture)
                                                • Separation of maxilla & zygoma (zygomaticomaxillary suture)
                                                • Zygomatic arch (zygomaticotemporal suture)
                                            • ZMC fracture terminology most universally accepted
                                              • Trimalar or tripod fracture terminology fails to acknowledge fracture of lateral orbital wall (zygomaticosphenoid suture)
                                          • Definitions

                                            • Fracture complex with fracture lines involving zygomatic arch, lateral orbital wall, anterior & lateral walls of maxillary sinus, & orbital floor

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    • Staging, Grading, & Classification

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              Selected References

                                                              1. Winegar BA et al: Spectrum of critical imaging findings in complex facial skeletal trauma. Radiographics. 33(1):3-19, 2013
                                                              2. Buchanan EP et al: Zygomaticomaxillary complex fractures and their association with naso-orbito-ethmoid fractures: a 5-year review. Plast Reconstr Surg. 130(6):1296-304, 2012
                                                              3. Fraioli RE et al: Facial fractures: beyond Le Fort. Otolaryngol Clin North Am. 41(1):51-76, vi, 2008
                                                              4. Hopper RA et al: Diagnosis of midface fractures with CT: what the surgeon needs to know. Radiographics. 26(3):783-93, 2006
                                                              5. Linnau KF et al: Imaging of high-energy midfacial trauma: what the surgeon needs to know. Eur J Radiol. 48(1):17-32, 2003
                                                              6. Salvolini U: Traumatic injuries: imaging of facial injuries. Eur Radiol. 12(6):1253-61, 2002
                                                              7. Sun JK et al: Imaging of facial trauma. Neuroimaging Clin N Am. 12(2):295-309, 2002
                                                              8. Rhea JT et al: Helical CT and three-dimensional CT of facial and orbital injury. Radiol Clin North Am. 37(3):489-513, 1999
                                                              9. Daffner RH: Imaging of facial trauma. Curr Probl Diagn Radiol. 26(4):153-84, 1997