A patient sustains a blow to the zygoma and presents with trismus, flattening of the cheek, anaesthesia of the cheek and upper lip, and diplopia on upward gaze. The most likely injury is:

• A Isolated zygomatic arch fracture
• B Blow-out fracture of the orbital floor
• C Le Fort II fracture
• D Tripod (zygomaticomaxillary complex) fracture ✓

Explanation

A tripod (zygomaticomaxillary complex/ZMC) fracture involves fractures at three articulations: frontozygomatic suture, zygomaticomaxillary suture, and the zygomatic arch, plus the orbital floor. This explains: cheek flattening (depressed zygoma), trismus (displaced arch impinging on coronoid process), infraorbital nerve anaesthesia (cheek/upper lip/upper teeth), and diplopia from orbital floor disruption. Pure blow-out fractures involve only the orbital floor with intact orbital rim.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.