Zygomaticomaxillary (tripod) fracture - Revision history

Rossdonaldson1: /* Background */

2021-09-25T13:34:40Z

Background

← Older revision		Revision as of 13:34, 25 September 2021
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	*Also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture		*Also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture
	*Definition = fracture through:		*Definition = fracture through:
	**Inferior orbital rim		*#Inferior orbital rim
	**Lateral orbital wall		*#Lateral orbital wall
	**[[Zygomatic arch fracture\|Zygomatic arch]]		*#[[Zygomatic arch fracture\|Zygomatic arch]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Evaluation */

2021-09-25T13:34:25Z

Evaluation

← Older revision		Revision as of 13:34, 25 September 2021
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	==Evaluation==		==Evaluation==
	[[File:PMC4145677 eplasty14ic27 fig1.png\|thumb\|~~MCT~~ scan demonstrating a depressed zygomaticomaxillary complex fracture with loss of projection (top left), displacement at the sphenozygomatic suture (top right), zygomaticomaxillary buttress (bottom right), with minimal orbital floor displacement (bottom left).]]		[[File:PMC4145677 eplasty14ic27 fig1.png\|thumb\|CT scan demonstrating a depressed zygomaticomaxillary complex fracture with loss of projection (top left), displacement at the sphenozygomatic suture (top right), zygomaticomaxillary buttress (bottom right), with minimal orbital floor displacement (bottom left).]]
	[[File:PMC4772575 AMS-5-262-g001.png\|thumb\|Left zygomaticomaxillary complex fracture with associated orbital fracture.]]		[[File:PMC4772575 AMS-5-262-g001.png\|thumb\|Left zygomaticomaxillary complex fracture with associated orbital fracture.]]
	*CT sinus/face		*CT sinus/face

Rossdonaldson1: /* Background */

2021-09-25T13:19:12Z

Background

← Older revision		Revision as of 13:19, 25 September 2021
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	==Background==		==Background==
	*Must distinguish zygomaticomaxillary (tripod) fracture from [[zygomatic arch fracture]]		*Must distinguish zygomaticomaxillary (tripod) fracture from [[zygomatic arch fracture]]
			*Also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture
	*Definition = fracture through:		*Definition = fracture through:
	**Inferior orbital rim		**Inferior orbital rim
	**Lateral orbital wall		**Lateral orbital wall
	**Zygomatic arch		**[[Zygomatic arch fracture\|Zygomatic arch]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Evaluation */

2021-09-25T13:15:38Z

Evaluation

← Older revision		Revision as of 13:15, 25 September 2021
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	==Evaluation==		==Evaluation==
			[[File:PMC4145677 eplasty14ic27 fig1.png\|thumb\|MCT scan demonstrating a depressed zygomaticomaxillary complex fracture with loss of projection (top left), displacement at the sphenozygomatic suture (top right), zygomaticomaxillary buttress (bottom right), with minimal orbital floor displacement (bottom left).]]
	[[File:PMC4772575 AMS-5-262-g001.png\|thumb\|Left zygomaticomaxillary complex fracture with associated orbital fracture.]]		[[File:PMC4772575 AMS-5-262-g001.png\|thumb\|Left zygomaticomaxillary complex fracture with associated orbital fracture.]]
	*CT sinus/face		*CT sinus/face

Rossdonaldson1: /* Evaluation */

2021-09-25T13:10:42Z

Evaluation

← Older revision		Revision as of 13:10, 25 September 2021
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	==Evaluation==		==Evaluation==
			[[File:PMC4772575 AMS-5-262-g001.png\|thumb\|Left zygomaticomaxillary complex fracture with associated orbital fracture.]]
	*CT sinus/face		*CT sinus/face
	*Ocular exam to evaluate for concomitant orbital injury (e.g. [[retrobulbar hematoma]], [[ruptured globe]])		*Ocular exam to evaluate for concomitant orbital injury (e.g. [[retrobulbar hematoma]], [[ruptured globe]])

ClaireLewis: /* Management */

2019-09-30T23:09:24Z

Management

← Older revision		Revision as of 23:09, 30 September 2019
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	*Surgical consult		*Surgical consult
	*Optho consult if ocular signs/symptoms		*Optho consult if ocular signs/symptoms
	*Antibiotic prophylaxis if extends into paranasal sinuses ([[~~Amoxicillin/Clavulanate~~]], [[doxycycline]], or [[clindamycin]])		*Antibiotic prophylaxis if extends into paranasal sinuses ([[amoxicillin-clavulanate]], [[doxycycline]], or [[clindamycin]])
	**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>		**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>
	**No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)		**No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)

Mholtz at 03:34, 29 September 2019

2019-09-29T03:34:41Z

← Older revision		Revision as of 03:34, 29 September 2019
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	*Must distinguish zygomaticomaxillary (tripod) fracture from [[zygomatic arch fracture]]		*Must distinguish zygomaticomaxillary (tripod) fracture from [[zygomatic arch fracture]]
	*Definition = fracture through:		*Definition = fracture through:
	*#Inferior orbital rim		**Inferior orbital rim
	*#Lateral orbital wall		**Lateral orbital wall
	*#Zygomatic arch		**Zygomatic arch

	==Clinical Features==		==Clinical Features==
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	==Evaluation==		==Evaluation==
	*CT face		*CT sinus/face
	*~~Rule-out associated ocular injuries or other trauma~~ (e.g. [[retrobulbar hematoma]], [[ruptured globe]])		*Ocular exam to evaluate for concomitant orbital injury (e.g. [[retrobulbar hematoma]], [[ruptured globe]])

	==Management==		==Management==
	*[[Analgesia]]		*[[Analgesia]]
	*~~OMFS/ENT~~ consult		*Surgical consult
	*Optho consult if ocular signs/symptoms		*Optho consult if ocular signs/symptoms
	*Antibiotic prophylaxis if extends into paranasal sinuses ([[~~amoxicillin~~]]~~, fluoroquinolone~~, [[doxycycline]], or [[clindamycin]])		*Antibiotic prophylaxis if extends into paranasal sinuses ([[Amoxicillin/Clavulanate]], [[doxycycline]], or [[clindamycin]])
	**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>		**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>
	***No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)		**No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)
	*Usually requires surgical repair		*Usually requires surgical repair

	==Disposition==		==Disposition==
	*~~Loss of vision or displacement: admit for IV antibiotics and~~ surgery		*Based on discussion with surgery
			**Generally may be discharged with outpatient surgical followup in 1 week

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>


	[[Category:ENT]]		[[Category:ENT]]
	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	[[Category:Trauma]]		[[Category:Trauma]]

ClaireLewis at 03:52, 24 September 2019

2019-09-24T03:52:49Z

← Older revision		Revision as of 03:52, 24 September 2019
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	==Clinical Features==		==Clinical Features==
	*Facial trauma (blunt, medially-directed force or high-energy decceleration)		*[[Facial trauma]] (blunt, medially-directed force or high-energy decceleration)
	*Normally depression of tripod (cheekbone) complex		*Normally depression of tripod (cheekbone) complex
	*Lower eyelid/cheek pain, swelling, and ecchymosis		*Lower eyelid/cheek pain, swelling, and ecchymosis
	*+/- Diplopia with upward gaze (due to extraocular muscle contusion/entrapment, orbital hematoma)		*+/- [[Diplopia]] with upward gaze (due to extraocular muscle contusion/entrapment, orbital hematoma)
	*+/- Trismus		*+/- Trismus
	*+/- Epistaxis		*+/- [[Epistaxis]]
	*+/- Paresthesias of lower lid, cheek, nose, upper lip if injury to infraorbital nerve		*+/- [[Paresthesias]] of lower lid, cheek, nose, upper lip if injury to infraorbital nerve

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Management==		==Management==
	*Analgesia		*[[Analgesia]]
	*OMFS/ENT consult		*OMFS/ENT consult
	*Optho consult if ocular signs/symptoms		*Optho consult if ocular signs/symptoms

Rossdonaldson1: /* Management */

2018-08-19T17:30:01Z

Management

← Older revision		Revision as of 17:30, 19 August 2018
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	==Management==		==Management==
			*Analgesia
	*OMFS/ENT consult		*OMFS/ENT consult
	*Optho consult if ocular signs/symptoms		*Optho consult if ocular signs/symptoms
	*Analgesia
	*Antibiotic prophylaxis if extends into paranasal sinuses ([[amoxicillin]], fluoroquinolone, [[doxycycline]], or [[clindamycin]])		*Antibiotic prophylaxis if extends into paranasal sinuses ([[amoxicillin]], fluoroquinolone, [[doxycycline]], or [[clindamycin]])
	**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>		**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>

Rossdonaldson1 at 17:29, 19 August 2018

2018-08-19T17:29:28Z

← Older revision		Revision as of 17:29, 19 August 2018
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	==Background==		==Background==
	*Must distinguish [[~~Zygomatic Arch Fracture~~]] ~~from Zygomaticomaxillary (Tripod) Fracture~~		*Must distinguish zygomaticomaxillary (tripod) fracture from [[zygomatic arch fracture]]
	*Definition = fracture through:		*Definition = fracture through:
	*#Inferior orbital rim		*#Inferior orbital rim
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	**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>		**For non-operative fractures into sinus, may not need prophylactic antibiotics <ref>Malekpour, M., Bridgham, K., Neuhaus, N., Widom, K., Rapp, M., Leonard, D., … Wild, J. (2016). Utility of Prophylactic Antibiotics in Nonoperative Facial Fractures. The Journal of Craniofacial Surgery, 27(7), 1677–1680.</ref>
	***No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)		***No difference in soft tissue infections in three groups (no prophylaxis, short course, long course)
	*Usually requires ~~admission and~~ surgical repair		*Usually requires surgical repair

	==Disposition==		==Disposition==