Zygomatic complex fractures in the emergency department: diagnosis and management

Falls, assaults, road traffic accidents and sporting injuries are some of the common causes of facial bone fractures. Fractures to the zygomatic complex, or cheekbone, are one of the most common fractures to the facial skeleton. These fractures can be easily missed on assessment and examination and thus left undiagnosed. This can lead to aesthetic deformities to the facial region and, rarely, orbital compartment syndrome due to a retrobulbar haemorrhage or other ocular complications. Emergency department advanced nurse practitioners are usually the clinicians responsible for ensuring that patients with zygomatic complex fractures are screened, investigated and escalated appropriately. The aim of this article is to inform readers of the strategies and methods for diagnosing and managing patients with zygomatic complex fractures, including when these types of injuries need to be referred to the oral and maxillofacial team.