Professional Documents
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UNIVERSIDAD DE MANILA
(Formerly City College of Manila)
Mehan Gardens, Manila
College of Nursing
(HEENT)
Submitted by:
Costales, Butch V.
NR-22
Submitted to:
Clinical Instructor
Date Submitted
Introduction
The zygomatic bone occupies a prominent and important position in the facial skeleton. It
plays a key role in determining facial width as well as acting as a major support of the midface.
Its anterior projection forms the malar eminence and is often referred to as the malar bone. The
zygoma has several important articulations in significant portion of the floor and lateral wall of
the orbit. In addition, the zygoma meets the lateral skull to form the zygomatic arch.
Fractures of the zygomatic complex are among the most frequent in maxillofacial trauma.
The zygomatic complex is responsible for the mid-facial contour and for the protection of the
orbital contents. The etiology of zygomatic complex fractures include road traffic accidents,
The study of Obuekwe, Owotade, and Osaiyuwu has shown that road traffic accidents are
responsible for most zygomatic complex fractures in our environment. Urgent enforcement of
road traffic legislation is necessary to minimize zygomatic complex fractures due to road traffic
accidents.
Pathophysiology
The zygoma is the main buttress between the maxilla and the skull, but, in spite of its
sturdiness, its prominent location makes it prone to fracture. The mechanism of injury usually
involves a blow to the side of the face from a fist, from an object, or secondary to motor vehicle
accidents. Moderate force may result in minimally or nondisplaced fractures at the suture lines.
More severe blows frequently result in inferior, medial, and posterior displacement of the
zygoma. Comminuted fractures of the body with separation at the suture lines are most often the
The zygoma has 2 major components, the zygomatic arch and the body. The arch forms
the the inferior and lateral orbit, and the body forms the malar eminence of the face. Fractures to
the zygoma are usually the result of blunt trauma. Direct blow to the arch can result in isolated
arch fractures. These are the most common. While tripod fractures are more serious and are
In general, displaced fractures involve the inferior orbital rim and orbital floor, the
zygomaticofrontal suture, the zygomaticomaxillary buttress, and the zygomatic arch. However,
occasionally, a direct blow to the arch results in an isolated depressed fracture of the arch only.
Types
Zygomatic Arch Fracture- can fracture in 2-3 places along the arch.
2. Fracture in the middle of the arch causing a V fracture which could impinge on the
temporalis muscle.
>Pain in cheek and jaw movement and limited mandibular movement which is due to
>Zygomatic arch
>Zygomaticofrontal suture
Clinical features:
and a computed tomographic (CT) scan. The CT scan has now essentially replaced plain films as
the gold standard in both evaluation and treatment planning. If physical findings and plain films
are not suggestive of a zygomatic fracture, the evaluation may end here. However, if they do
suggest fracture, a coronal and axial CT scan should be obtained. The CT scan will accurately
reveal the extent of orbital involvement, as well as degree of displacement of the fractures. This
Nursing Management
Perioperative nursing care of patients with zygomatic complex fracture
Stomatological Department of Yongkang First People's Hospital, Yongkang 321300, Zhejiang Province, China
This study of the researchers Shi BM, Yang QF and Zhou MX suggests that key points of
perioperative nursing are psychological nursing, including elimination of fear and pessimism.In
addition, nurses should take active hemostatic, antishock as well as, anti-infection measures with
Treatment
Medical Therapy
If surgical correction is performed, prescribe prophylactic antimicrobial therapy if a
Surgical Therapy
Reconstruction of the zygomatic arch following injury is necessary for restoration of
malar symmetry and support for the maxilla and masticatory loads. Repair of the zygomatic arch
stabilization. In 1999, Turk et al found that direct repair and plating of the zygomatic arch was
not indicated in more than 1500 patients, secondary to spontaneous reduction with repair of other
As with all surgical procedures, successful outcomes are the result of a planned approach
that affords excellent exposure of the operative site and of the use of meticulous surgical
technique. More specifically, repair of zygomatic arch fractures requires a precise reduction and
>Broad spectrum antibiotics since the fracture crosses into the maxillary sinus.
>Tetanus Toxoid
Displaced tripod fractures usually require admission for open reduction and internal
fixation
>Zygomatic arch
The Zygomatic Bone occupies a prominent and >Inferior orbital rim and floor
important position in the facial skeleton.
Etiology SS/Sx