ZMC Fracture Definition

Zygomaticomaxillary Buttress is a vertically-oriented major structural support to midface and upper face. This support must be restored during surgical repair.

Minor structural support is provided by infraorbital rim and zygomatic arch.  As such, zygomatic arch fractures do not need to be routinely plated.

Key Visual Reference for ZMC Fracture Bone Reduction

Key Surgical Anatomy

Overview of Surgical Repair

Surgical Pearls

• Determine best surgical approach based on the location of a fractures that require plating.  Be aware of the outer limits of what is reachable when using a particular approach for plating.

• Consider bone reduction using a J-shaped urethral dilator.

• Consider using the following plating sequence shown below to work from easy to harder fracture site. 

Plate Configuration

Closure

ZMC Fracture Pattern Classification based on Treatment Algorithm

Type 1A-1C addresses zygomatic arch fracture segment

Type 2-6 addresses ZMC fracture segment with increasing complexity