Fractures of the zygomatic-maxillar complex.

By Dr. Vishaal Bhat on Monday 26 November 2007 with 0 comments



These are far the most common fractures of the facial middle third. A characteristic configuration of the face is formed by prominence of zygomatic bones at the latero-ventral direction. A side impact onto this area causes not only an isolated damage of a zygomatic bone (very rarely), but it gets also broken off the surrounding bone structures due to its rigidity. Those structures get damaged as well thanks to their anatomical forms. Fracture lines thus often run across bone structures. A cranial loosening appears at the zygomatic-frontal suture, from where a line runs on the outer surface of an orbit along the connection of zygomatic bones with large alae of the sphenoid bone towards fissura orbitalis inferior. A breakage crosses from here to the connection of zygomatic bones with orbital parts of the maxilla. Around the lower orbit’s edge it runs at the site of zygomatic-maxillar suture nearby foramen infraorbitale from the front surface of maxillary sinus to its lateral wall where several fracture lines are formed. The wall is shattered into many fragments, and the zygomatic-alveolar crista is damaged, too. This crista makes a lateral reinforcement of the facial middle third and transfers a mastication pressure upwards. The fracture line proceeds on the lateral side upwards to fissura orbitalis inferior again. The malar arch is usually broken as well. The most frequent causes include a direct impact of head turned aside to a barrier or hitting by an object (fist) on a zygomatic bone’s body. Dislocations at various directions occur, depending on intensity of a causal force. If the whole bone complex gets broken off, backwards and downwards dislocations are mostly found.

Category: Oro-Maxillo Facial Surgery Notes

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