Comparison of ultrasonography with conventional radiography in the diagnosis of zygomatic complex fractures.

PURPOSE: Zygomatic complex fractures have changed in patterns of occurrence, severity, and, more importantly, in the mode of injury. Protection of the globe and maintaining the width of the face are the more important roles of the complex. Diagnosis and treatment planning of such fractures become imperative in the sequencing of repair if and where indicated, especially in the case of isolated zygomatic complex fractures. Exploring the versatility of ultrasonography (US), in diagnosing zygomatic complex fractures in comparison to conventional radiography in a double-blind study, the objective of this study was to evaluate the efficacy of US and to explore the possibility of making US examination a mainstay in the primary diagnosis of such fractures.

MATERIAL AND METHOD: The prospective, double-blind study design included 32 patients suspected of having sustained isolated zygomatic complex fractures. The patients underwent US examination and radiographic examination in the form of para-nasal sinus (PNS) and sub-mentovertex (SMV) views for comparison.

RESULTS: A sensitivity of 100% was seen in favor of US in the areas of the fronto-zygomatic suture (FZ), arch, infra-orbital, and buttress areas. Statistically significant differences (p < .01) was seen in areas of the arch and buttress region and in the infra-orbital area.

CONCLUSION: Although US showed 100% sensitivity in detection of fracture lines at three articulations of the four that make up the zygomatic complex, it lacked in quantifying the amount and degree of displacement of the fractured segments, which hampered accurate treatment planning.