Background

Traffic accidents are the leading cause of the maxillofacial fractures from the
observation made from the study. Study revealed that the common cause for the facial
fractures was found to be traffic accidents (72.7%) with a male preponderance and peak
incidence during 20–30 years of age. Isolated mandibular fractures were most frequent [1035
patients (41.7%)] followed by isolated mid face fractures [526 patients (21.2%)]. Among mid
face fractures, zygomatic bone and arch were most frequently involved. Open reduction and
internal fixation and closed method were used in almost the same frequency. (Shankar, A. N.
Shankar,V.N. Hegde,N. Sharma, and Prasad, R, 2012).

Zygomatic arch fractures are common injuries, occurring in isolation in 5% of all

patients with facial fractures and in 10% of patients with any fracture to the
zygomaticomaxillary complex. Isolated noncomminuted depressed zygomatic arch fractures
are easily treated with the minimally invasive Gillies approach, which most often provides
long-term stability. (Swanson, Edward BAS. Vercler, Christian MD. Yaremchuk, Michael J.
MD and Gordon, Chad R. DO. 2012).

The zygomatic bone occupies a prominent and important position in the facial
skeleton. The zygoma forms a significant portion of the floor and lateral wall of the orbit and
forms a portion of the zygomatic arch, otherwise known as the malar eminence, which plays
a key role in the determination of facial morphology. (Seiff, Stuart. MD, FACS, and
DeAngelis, D, MD, FRCSC. 2014).

Anatomically, the zygomatic bone contains foramina that allow for the passage of
zygomaticofacial and zygomaticotemporal arteries and corresponding nerves of the second
division of the trigeminal nerve that supply sensation to cheek and anterior temple. Similarly,
the infraorbital nerve also courses the floor of the orbit and exits the infraorbital foramen or
notch. Consequently, fractures of the zygomatic arch can lead to hypoesthesia in the
corresponding dermatome. Muscle attachments along the zygomatic arch include the origin
of the masseter, the zygomaticus major, and some fibers of the temporalis fascia. The
Whitnall tubercle, which serves a critical role in the maintenance of eyelid contour as the
attachment site for the lateral canthal tendon, is located on the zygomatic bone 2 mm behind
the lateral orbital rim. (Seiff, Stuart. MD, FACS, and DeAngelis, D, MD, FRCSC. 2014).
Shankar, A. N. Shankar,V.N. Hegde,N. Sharma, and Prasad, R. 2012. The pattern of the
maxillofacial fractures – A multicentre retrospective study. Journal of Cranio-Maxillofacial
Surgery, Volume 40, Issue 8, Pages 675-679.

Swanson, Edward BAS. Vercler, Christian MD. Yaremchuk, Michael J. MD and Gordon,
Chad R. DO. 2012. Modified Gillies Approach for Zygomatic Arch Fracture Reduction in the
Setting of Bicoronal Exposure. Journal of Craniofacial Surgery, Volume 23, Issue 3, p 859–
862.

Seiff, Stuart. MD, FACS, and DeAngelis, D, MD, FRCSC. 2014. Zygomatic Orbital
Fracture. http://emedicine.medscape.com/article/1218360-overview#showall.