A curious case of zygomatico-maxillary complex fracture

ZMC fractures are fairly common in a trauma setting. A maxillofacial surgeon deals with them day in and day out. They are fairly easy to diagnose with modern investigative methods like CT scan, however in the absence of CT it can be diagnosed with a PNS x-ray combined with the clinical status of the patients. Treatment methods for the same have evolved over the years, and in spite of all the literature available, ZMC fracture treatment varies from no intervention at all, to elevation of the fractured segment alone, or sometimes an extensive ORIF with one, two or three point fixation according to the preferences of the surgeon. A case of minimally displaced anterolateral and postero lateral wall of maxillary bone fracture with excruciating pain reported to the casualty with a history of 14 days old trauma. To relive pain nerve block was administered which subsided the pain. Following which there was appearance of vesicles which were unilateral, the nature of the pain and the appearance of the vesicle led to a diagnosis of Pre Herpetic Neuralgia, with classical herpes zoster infection. Although the patient in this case presented with a history of trauma, it was the detail to attention and the involvement of the multidisciplinary approach that the correct diagnosis was made, the patient treated appropriately and discharged.