A Simple Scoring System to Predict Zygomatic Fracture
Siritongtaworn C, MD1, Pathanasri T, MD1
Affiliation : 1 Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : In Thailand, many patients with suspected facial fracture are primarily screened and diagnosed by newly graduated,
inexperienced general practitioners in rural and suburban hospitals. Some signs, symptoms and radiological findings that are easy
to detect may be common among patients with zygomatic fracture. These factors may help in diagnosis of this fracture that could
be used by general practitioners to reduce the rate of misdiagnosis.
Objective : The present study aims to find predictive factors for zygomatic fracture diagnosis and develop a scoring system that can
assist in diagnosis.
Materials and Methods : Medical records of patients older than 15 years with facial fracture clinic seen at Siriraj hospital between
1 January 2007 and December 2017 were reviewed. Data on demographics, associated injury, type of facial fracture, signs &
symptoms, and radiologic findings were extracted and recorded in predesigned case record form. The results of this multivariate
logistic regression were used to develop score to predict Zygomatic fracture.
Results : A total of 794 patients with 901 bone fractures met the inclusion criteria were included in the present study. There were
124 patients with zygomatic fracture. Five factors (Infraorbital nerve numbness, periorbital ecchymosis, point of tenderness,
discontinuity of inferior orbital rim, and haziness of maxillary sinus from plain x-ray) were significantly predictive of zygomatic
fracture from multivariate analysis and we develop a scoring system to predict zygomatic fracture by them.
Conclusion : Infraorbital nerve numbness, periorbital ecchymosis, point of tenderness, discontinuity of inferior orbital rim, and
haziness in maxillary sinus are significant predictors of zygomatic fracture. A scoring system using those factors is proposed in the
present study.
Keywords : Zygomatic fracture, Scoring system
