白袍恐懼症

Fracture of Zygoma: the most common facial fracture

1. Symptoms

Enophthalmos: avoid compressing infraorbital nerve

Malar asymmetry: Palpable bony defect over the arch

Diplopia

Trismus: Pain in cheek and jaw movement

Impingement on coronoid process

Flame sign: Intraoral hematoma , ecchymosis

Epistaxis

Inferior displacement of globe

Inferior displacement of lateral canthus

Infraorbital never injury: numbness

2. Diagnosis: CT scan

3. Classification

Group 1. No significant displacement.

Group 2. Arch fractures.

Group 3. Unrotated body fractures.

Group 4. Medially rotated body fractures.

Group 5. Laterally rotated body fractures.

Group 6. Include all cases with fracture lines cross the main fragment.

4. 5 places to align the zygoma

1) zygomatico‐maxillary buttress

2) lateral wall of the orbit

3) infraorbital rim

4) zygomatic arch

5) zygomatico‐frontal suture

5. Treatment

1) Isolated arch fracture Gillies approach

2) Displaced zygomatic fracture: ORIF(open reduction internal fixation)

3) Comminuted zygomatic fracture: ORIF,bone grafting , correction of enophthalmos

1. the temporal (Gillies) approach

2. the transoral (Keen) approach.

ORIF

Open Treatment without Orbital Repair

Simple fracture: 1‐point fixation with a plate may be adequate (Upper buccal sulcus approach)

Open Treatment with Orbital Repair

Upper buccal sulcus approach+ Lower eyelid incision and Transconjunctival approach