Zygomaticomaxillary (tripod) fracture

Background

• Must distinguish Zygomatic Arch Fracture from Zygomaticomaxillary (Tripod) Fracture
  • Tripod fx = fx of zygomatic arch, lat and inf orbital rims, lat wall of maxillary sinus

Differential Diagnosis

Maxillofacial Trauma

• Ears
  • Auricular hematoma
• Nose
  • Nasal fracture
  • Nasal septal hematoma
• Oral
  • Dental trauma
  • Lip laceration
  • Tongue laceration
• Other face
  • Le Fort fractures
  • Mandible fracture
• Zygomatic arch fracture
• Zygomaticomaxillary (tripod) fracture
• Related
  • Head trauma (main)
    • Skull fracture
    • Skull fracture (peds)
    • Basilar skull fracture
  • Orbital trauma
    • Eyelid laceration
  • Scalp laceration

Diagnosis

• Fracture through:
  • Inferior orbital rim
  • Lateral orbital wall
  • zygomatic arch
• Must r/o associated ocular injuries

Treatment

• Usually requires admission and surgical repair

Disposition

• Loss of vision or displacement: admit for IV abx and surg

See Also

• Maxillofacial trauma