This document discusses fractures of the zygomatic complex, which is part of the cheek bone. It begins with the surgical anatomy and classifications of fractures. Common signs and symptoms are outlined, including flattening of the cheek, swelling, bruising around the eye. Causes of complications like double vision and sunken eyes are explained. Techniques for reduction and fixation of fractures are described, including both closed and open reduction approaches as well as different surgical incisions.

1. ZZYYGGOOMMAA
DDrr VV..RRAAMMKKUUMMAARR
CCOONNSSUULLTTAANNTT
DDEENNTTAALL&&FFAACCIIOOMMAAXX
IILLLLAARRYY SSUURRGGEEOONN
RREEGG NNOO:: 44111188 ––
TTAAMMIILLNNAADDUU--
IINNDDIIAA((AASSIIAA))

2. TThhee zzyyggoommaa aanndd iittss aarrttiiccuullaattiinngg
bboonneess
IINTRODUCTION

3. SURGICAL ANATOMY

4. CLASSIFICATION
Fractures of the body of the zygomatic complex involving the orbit
1. Minimal or no displacement
2. Inward and downward displacement
3. Inward and posterior displacement
4. Outward displacement
5. Comminution of the complex as whole
Fractures of the body of the zygomatic complex not involving the orbit
1.Minimal or no displacement
2. V-type in fracture
3. Comminuted

7. Signs and Symptoms
1. Flattening of cheek
2. Swelling of cheek
3. Periorbital haematoma

8. HAEMORRHAGE

9. 4. Subconjunctival haemorrhage
5. Ecchymosis and tenderness intra-orally
zygomatic buttress.
6. Limitation of ocular movement.

10. 7. Diplopia:
Causes
1.Physical Interfences
Intramuscular edema
detachement of IR, IO
herniation of periorbital fat
fibrous adhesions & fat atrophy in post-traumatic healing
2.Functional interferences
displacement of globe due to disturbance of IR, IO
enophthalmous & globe ptosis.
3.Neurological cause
paralysis due to mneuromuscular injury or edema
supranuclear impairment of 3,4,6th C.N.
superior orbital fissure damage

12. 8.Enophthalmous:
Causes:
loss / decrease of vol. Of orbital content
increase in vol. Of bony orbit
loss of ligament support
post traumatic fibrosis, scar contraction, fat atrophy.
9.Lowering of pupil level
10.Epistaxis
11.Tenderness over orbital rim & FZS
12.Step deformity of infra orbital rim
13.Seperation at FZS
14.Limitation of mandibular movement
15.Anaesthesia of cheek, temple, upper teeth & gingiva
16.Possible gagging of back teeth on injured side

13. TTEECCHHNNIIQQUUEESS OOFF RREEDDUUCCTTIIOONN
AANNDD FFIIXXAATTIIOONN
RREEDDUUCCTTIIOONN
CCLLOOSSEEDD RREEDDUUCCTTIIOONN –– GGIILLLLIIEESS eett aall 11992277
OOPPEENN RREEDDUUCCTTIIOONN -- DDIINNGGMMAANN eett aall 11996644
-- KKEEEENN eett aall 11990099
 FFIIXXAATTIIOONN AAPPPPRROOAACCHHEESS
-- LLAATTEERRAALL EEYYEEBBRROOWW IINNCCIISSIIOONN
-- UUPPPPEERR BBUUCCCCAALL SSUULLCCUUSS IINNCCIISSIIOONN
-- LLOOWW IINNFFRRAA OORRBBIITTAALL IINNCCIISSIIOONN
-- OOTTHHEERRSS -- PPEERRCCUUTTAANNEEOOUUSS

14. PERCUTANEOUS APPROACH

16. PERI ORBITAL INCISIONS

17. INDIRECT REDUCTION

19. TThhaannkk yyoouu