COMPARATIVE-EVALUATION OF DIFFERENT RADIOGRAPHIC PROJECTIONS OF ZYGOMATIC COMPLEX FRACTURES

Diagnosis of zygomaticomaxillary fractures is a major problem in radio graphic interpretation. The purpose of the present study was to evalua te several radiographic examinations performed in an emergency room to diagnose zygomatic complex (ZC) fractures, in order to determine whic h is the single best radiographic projection for this purpose. Radiogr aphs of 160 patients with ZC fractures were evaluated retrospectively. The modified P-A projection (10-degrees-20-degrees) provided a clear image of the frontozygomatic, infra-orbital rim and temporozygomatic f racture tines in alt cases. In half the cases, the modified P-A projec tion also clearly demonstrated the fracture line in the zygomatic maxi llary buttress. On the other hand, the Water's view demonstrated the f racture line in the zygomatic maxillary buttress and the temporozygoma tic bone in all cases, but in only 65% of the cases was the fracture l ine in the infra-orbital rim and the frontozygomatic bones shown. The modified P-A projection was found to be the single best radiographic e xamination that should be performed in the emergency room to diagnose ZC fractures.