A patient involved in a road traffic accident develops flattening of the malar prominence, trismus, and numbness over the cheek and upper lip. CT shows a fracture of the zygomatic arch and orbital floor. This pattern is most consistent with:

• A Le Fort II fracture (pyramidal fracture)
• B Tripod (zygomaticomaxillary complex — ZMC) fracture ✓
• C Naso-orbito-ethmoid (NOE) fracture
• D Le Fort III fracture (craniofacial dysjunction)

Explanation

A tripod or ZMC (zygomaticomaxillary complex) fracture involves three sites: the zygomatic arch, the zygomaticofrontal suture, and the infraorbital rim/floor. Clinically it presents with flattening of the cheek (depressed zygoma), trismus (pterygoid impingement from depressed zygomatic arch), infraorbital nerve numbness (V2 — cheek, upper lip, teeth), and step deformity at the infraorbital rim. Le Fort fractures involve the maxilla as a whole; NOE fractures involve the central nasal complex.

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.