2.  52yo F presents after
MVC rollover. Pt was
restrained but no airbags
in vehicle.+LOC. C/O
headache and facial pain.
Double vision. Numbness
below eye.
 T 98.2 HR 80 BP 160/90
RR 18 PO2 100%
 Neuro: AAOx3
 HEENT: PERRLA, EOMI,
+Trismus, +lateral cheek
flattening, decreased
sensation below orbit

4. Arrowheads: Inf/Lat
Orbit Wall fx
1.Anterior Zygoma Fx
Arrows:air fluid level
in maxillary sinus
3.Medial Maxillary Sinus
Fx
2.Posterior Zygoma Fx

5.  Displaced
 Minimal/Non-Displaced
Admission
Normal Optho Exam
Internal Fixation
Soft Diet
Analgesics
OMFS f/u with
elective repair

6. 3 Fracture Components:
Zygomatic Arch
Lateral Orbit Wall
Inferior Orbital Floor
Usually need CT
Temporal bone
thickness obscures
subtle findings
Thorough Eye Exam
Important

7. Orbital emyphsema
from maxillary sinus
communication
Severe
displacement

8.  http://www.rad.washington.edu/academics/academic-
sections/msk/teaching-materials/online-musculoskeletal-radiologybook/facial-and-mandibular-fractures/?searchterm=tripod%20fracture
Mettler: Essentials of Radiology, 2nd ed.
Facial Trauma Chapter
Pascoto, A. Imaging in Orbital Fractures.
MedScape
alexandriaradiology.com
Tollefson, T. Zygomaticomaxillary complex
fractures. MedScape
 Tintanelli’s Emergency Medicine: A Comprehensive
Study Guide. Chapter 257 Maxillofacial Trauma