A 32-year-old male presents to the emergency department after being struck in the face with a baseball. He complains of severe pain and difficulty opening his mouth. On examination, you notice facial asymmetry and a step-off deformity along the right zygomatic arch. Which of the following is the most appropriate initial management for this patient?
The correct answer is to obtain a maxillofacial CT scan. In cases of suspected zygomatic arch fractures, a CT scan is the gold standard for diagnosis. It provides detailed imaging of the facial bones, allowing for accurate assessment of fracture patterns, displacement, and associated soft tissue injuries. This information is crucial for determining the appropriate treatment plan and potential need for surgical intervention.
While pain management is important, it should not delay proper diagnostic imaging. Immediate reduction of the fracture without proper imaging could lead to complications and is not recommended as the initial step. Administering antibiotics is not routinely indicated for all facial fractures unless there is evidence of infection or an open fracture communicating with the oral cavity or sinuses.
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Why is a maxillofacial CT scan the gold standard for diagnosing zygomatic arch fractures?
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Why is attempting immediate reduction of a zygomatic arch fracture without imaging not recommended?
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When are antibiotics indicated for facial fractures, and why are they not routinely given here?
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Maxillofacial and Ocular Emergencies
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