This document discusses clinical features and treatment of zygomatic complex fractures. Key clinical features include pain, swelling, tenderness, step deformity, flattening of the malar prominence and zygomatic arch. Other features can include circumorbital edema, ecchymosis, soft tissue emphysema, parasthesia of the infraorbital nerve, retrobulbar hemorrhage, altered globe position, subconjunctival hemorrhage, and diplopia. Treatment involves either direct open reduction using approaches like the lateral eyebrow, subciliary, midway, or infraorbital incisions, or indirect reduction using upper buccal sulcus, Gillies temporal, or percutaneous approaches.

1. ZMC
FRACTURE

2. CLINICAL FEATURES
* PAIN , SWELLING, TENDERNESS AND STEP
DEFORMITY IS COMMON FOR ALL FRACTURE
* FLATTENING OF MALLAR PROMINENCE.
* FLATTENING OF ZYGOMATIC ARCH DUE TO
FRACTURE .
* CIRCUM ORBITAL EDEMA AND ECCHYMOSIS .
* SOFT TISSUE EMPHYSEMA.

3. CONTD
• PARATHESIA OF INFRA ORBITAL NERVE DUE TO INJURY OF INFRA ORBITAL
NERVE.
• RETROBULBAR HEMORRHAGE IT IS MORE COMPLICATE THE CASE BECAUSE THE
PATIENT HAVE MORE CHANCE OF PERMANENT LOSS OF VISION DUE
COMPRESSION OF OPTIC NERVE.
• ALTER GLOB POSITION. GLOB POSITION IS MAINTAINED BY THE SUSPENSORY
LIGAMENT OF LOCKWOOD. IT MAINTAINS THE VERTICAL POSITION OF GLOBE.
• LOCKWOOD IS ATTACHED IN LATERAL ASPECT OF WHITNALS TUBERCLE.
• DUE TO INFERIOR DISPLACEMENT OF WHITNALS TUBERCLE IT WILL LEADS TO
ALTER THE GLOBE POSITION

4. CONTD
• SUBCONJUNCTIVAL HEMORRHAGE ON LATERAL ASPECT.

5. • DIPLOPIA – DOUBLE VISION.
• TYPES SINGLE EYE OR BOTH EYES.
• DUE TO INJURY IN EYES IT MAY BE A TRAUMATIC OR COMPLICATIONS OF LA
TECHNIQUES.

6. TREATMENT

7. • TYPES OF APPROACHES.
1 . LATERAL EYEBROW APPROACH
2 . SUBCILLIARY INCISION BELOW THE EYE BALL
3 MIDWAY INCISION 5 TO 6 MM BELOW THE EYE LASHES
4 INFRAORBITAL INCISION.

8. INDIRECT
REDUCTION
• UPPER BUCCAL AULCUS APPROACHES
•GILLIS TEMPORALS APPROACHES
• PERCUTANEOUS APPROACHES.