Emergency Department

Zygoma Fractures



  • Zygomatic Fractures (ZMF) or “cheek bone fractures” usually are referred to Zygomatic Complex Fractures (ZCF) due to the relationship with other different structures.


  • The term “Tripod Fracture” describes the fracture involving three main structures: Zygomatic arch, infraorbital rim and fronto-zygomatic suture. Some argue the term is misused, as there is usually involvement of the Zygomatic buttress also.


  • ZMF are not life-threatening injuries, and in most cases these will require a re-assessment 5 to 7 days (no more) after the injury as the presenting swelling can difficult the clinical examination and will be treated electively.


  • Always rule out head / brain injury, an Emergency Head CT could be required.


  • In these injuries the most important structure to constantly assess is the Eye and the visual acuity.


  • Usually ZMF will not require immediate treatment unless a Retrobulbar Haemorrhage has developed transforming this in a true emergency as the Eye’s vitality and function can get permanently damaged in a short period of time.


  • Assess the Eye with a Snellen Chart (see Snellen Chart tool within this app) and document any diplopia and visual disturbance detected. This is mandatory.


  • Patient’s presenting difficulties opening or closing the mandible will most likely have a medially displaced fractured Zygomatic Arch and this will require attention quiet soon due to secondary trauma to TMJ structures.



Author: Arie Yuffa

Last updated: 21/02/15