Pediatric Tripod Fracture

  • Etiology: Trauma to zygomatic complex
  • Imaging CT:
    — 4 parts: Lateral wall maxillary sinus, orbital rim and infraorbital foramen, orbital floor, zygomatical frontal suture and zygomatic arch
    — Orbit involvement often incomplete – Lateral wall and floor of orbit
    — Zygomatic arch involvement – Inspect all processes – frontal, temporal, maxillary
    — Coronoid process impingement
  • Note: On maxillofacial trauma CT an air-fluid level in sinus is a clue that a fracture is present
  • DDX:
  • Complications: If there is extension into a paranasal sinus the fracture is considered dirty
  • Treatment:
  • Clinical:

Radiology Cases of Tripod Fracture

CT of pediatric tripod fracture
Axial (left and above right) and coronal (middle right and below right) CT without contrast of the face show multiple right-sided facial fractures including the lateral orbital wall, inferior orbital wall, lateral wall of the maxillary sinus, and anterior aspect of the zygomatic arch along with a plastic deformity of the posterior aspect of the zygomatic arch.