Zygomatic arch fracture

Must distinguish zygomatic arch fx from zygomaticomaxillary (tripod) fx
- Tripod fx = fx of zygomatic arch, lat and inf orbital rims, lat wall of maxillary sinus
Exam
- Flattening of malar eminence
- Eye findings
  - Eye may appear to tilt (pulling of lateral canthus)
  - Subconjunctival hemorrhage
- Trismus (masseter spasm or impingement of temporalis muscle or coronoid process)
  - Palpate posterior surface of arch for tenderness/loss of space compared to other side
Management
- Facial CT
Disposition
- Isolated zygomatic arch fx: discharge
- Tripod fx w/ loss of vision or displacement: admit for IV abx and sx

See Also