A pure zygomatic arch fracture should be suspected in a patient who has pain, swelling, or a palpable step-off along the zygomatic arch, but no other findings in the area of the zygomaticofrontal area or the inferior orbital rim. Another common sign is trismus.
The diagnosis of a pure zygomatic arch fracture can readily be confirmed on an axial CT.
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Submental vertex (bucket-handle) plain x-rays may also be useful in confirming the diagnosis.