Zygomatic Bone Fracture (Non-Displaced): Causes, Symptoms, and Treatment

What is Zygomatic Bone Fracture (Non-Displaced)?

A non-displaced zygomatic bone fracture is a crack or break in the zygomatic bone (cheekbone) that does not cause the bone to shift out of its normal position. The zygomatic bone forms the prominence of the cheek and contributes to the structure of the eye socket and the side of the face. Unlike displaced fractures, non-displaced fractures maintain proper alignment, which often leads to simpler treatment and recovery.

This type of fracture is common in facial injuries and can result from various types of trauma. While it may not always be immediately visible, it can cause discomfort, swelling, and other symptoms that require medical attention.

Source: Mayo Clinic, National Institutes of Health (NIH)

Common Causes

Non-displaced zygomatic bone fractures typically occur due to direct trauma to the face. Common causes include:

• Motor vehicle accidents: High-impact collisions can cause facial injuries, including zygomatic fractures.
• Falls: Tripping, slipping, or falling from a height can lead to facial trauma.
• Sports injuries: Contact sports like football, hockey, or boxing increase the risk of facial fractures.
• Physical altercations: Punches or blows to the face during fights can result in zygomatic fractures.
• Assaults: Intentional harm, such as being struck with an object, can cause this type of injury.
• Workplace accidents: Industrial or construction-related incidents may lead to facial trauma.
• Bicycle or motorcycle accidents: Even with helmets, facial injuries can occur during crashes.
• Recreational activities: Activities like skateboarding or skiing carry a risk of falls and facial injuries.
• Domestic accidents: Accidental impacts from household objects or furniture.
• Animal attacks: Bites or scratches from animals, particularly dogs, can cause facial fractures.

Source: Centers for Disease Control and Prevention (CDC), NIH - Facial Fractures

Associated Symptoms

Symptoms of a non-displaced zygomatic bone fracture may vary depending on the severity of the injury. Common signs and symptoms include:

• Pain and tenderness: Discomfort around the cheekbone, which may worsen with touch or movement.
• Swelling: Visible swelling around the cheek or under the eye.
• Bruising: Discoloration (black and blue marks) around the eye or cheek.
• Numbness: Loss of sensation in the cheek, upper lip, or around the eye due to nerve involvement.
• Difficulty opening the mouth: Pain or limited movement when chewing or speaking.
• Flattening of the cheek: In some cases, the cheek may appear less prominent.
• Double vision or blurred vision: If the fracture affects the eye socket.
• Nosebleeds: If the fracture extends to the nasal area.
• Headache: Persistent or localized pain around the temple or forehead.

In some cases, symptoms may be mild, and the fracture may not be immediately obvious. However, any facial trauma should be evaluated by a healthcare professional to rule out complications.

Source: Cleveland Clinic, NIH - Zygomatic Fractures

When to See a Doctor

It is important to seek medical attention if you experience any of the following after facial trauma:

• Persistent pain or swelling in the cheek or around the eye.
• Difficulty moving your jaw or opening your mouth.
• Numbness or tingling in the face, particularly around the cheek or upper lip.
• Changes in vision, such as double vision or blurred vision.
• Severe headaches or dizziness.
• Signs of infection, such as fever, increased pain, or pus around the injury site.
• Bleeding from the nose or ears that does not stop.

Even if symptoms seem mild, a healthcare provider can perform imaging tests to confirm the presence of a fracture and recommend appropriate treatment.

Source: World Health Organization (WHO), UpToDate

Diagnosis

Diagnosing a non-displaced zygomatic bone fracture typically involves a combination of physical examination and imaging tests. Here’s what to expect during the diagnostic process:

Physical Examination

A healthcare provider will:

• Inspect the face for swelling, bruising, or deformities.
• Palpate (feel) the cheekbone and surrounding areas for tenderness or irregularities.
• Check for numbness or changes in sensation around the face.
• Assess jaw movement and look for signs of pain or limitation.
• Evaluate vision and eye movement to rule out complications.

Imaging Tests

To confirm the diagnosis and assess the extent of the fracture, the following imaging tests may be ordered:

• X-rays: Provide a basic view of the bone structure and can confirm the presence of a fracture.
• CT scan (Computed Tomography): Offers detailed cross-sectional images of the facial bones, helping to determine if the fracture is displaced or if there are associated injuries.
• MRI (Magnetic Resonance Imaging): Less commonly used but may be ordered if soft tissue or nerve damage is suspected.

These tests help the healthcare provider determine the best course of treatment and rule out complications such as damage to the eye socket or nearby nerves.

Source: Radiopaedia, NIH - Imaging in Facial Fractures

Treatment Options

Treatment for a non-displaced zygomatic bone fracture focuses on managing symptoms, promoting healing, and preventing complications. Since the bone is not out of alignment, surgical intervention is often unnecessary. Treatment options include:

Medical Treatments

• Pain management: Over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol) can help manage discomfort. In some cases, a healthcare provider may prescribe stronger pain medication.
• Anti-inflammatory medications: These can help reduce swelling and inflammation around the injury site.
• Antibiotics: If there is a risk of infection, particularly if the fracture is open (the skin is broken), antibiotics may be prescribed.
• Tetanus shot: If the skin is broken, a tetanus vaccination may be recommended to prevent infection.

Home Care and Lifestyle Adjustments

• Rest: Avoid strenuous activities that could worsen the injury or delay healing.
• Ice packs: Apply ice to the affected area for 15-20 minutes every hour during the first 48 hours to reduce swelling. Use a cloth to protect the skin from direct contact with ice.
• Elevation: Keep your head elevated, especially when sleeping, to minimize swelling.
• Soft diet: Eat soft foods to avoid putting pressure on the jaw and cheekbone. Avoid chewing on the affected side.
• Avoid nose-blowing: If the fracture involves the sinuses, blowing your nose can increase pressure and worsen symptoms.
• Protect the injury: Avoid activities that could lead to further trauma, such as contact sports, until the fracture has healed.

Follow-Up Care

Regular follow-up appointments with a healthcare provider are important to monitor healing. During these visits, the provider may:

• Check for signs of complications, such as infection or nerve damage.
• Assess bone healing through physical examination or repeat imaging.
• Adjust pain management or other treatments as needed.

Most non-displaced zygomatic fractures heal within 4 to 6 weeks with proper care. However, healing time can vary depending on the individual and the severity of the injury.

Source: Mayo Clinic, NIH - Facial Fracture Management

Prevention Tips

While not all zygomatic bone fractures can be prevented, taking precautions can reduce the risk of facial injuries. Here are some practical tips:

• Wear protective gear: Use helmets, face shields, or mouthguards during sports or activities with a risk of facial trauma (e.g., cycling, skiing, boxing).
• Drive safely: Always wear a seatbelt in vehicles and follow traffic rules to minimize the risk of accidents.
• Prevent falls: Use handrails on stairs, keep walkways clear of clutter, and use non-slip mats in bathrooms.
• Avoid altercations: Steer clear of physical confrontations that could lead to facial injuries.
• Childproof your home: Ensure that children’s play areas are safe and free from sharp or hard objects.
• Use caution with animals: Be mindful around pets or unfamiliar animals to avoid bites or scratches.
• Wear appropriate footwear: Shoes with good traction can help prevent slips and falls.
• Follow workplace safety guidelines: Use protective equipment and adhere to safety protocols in high-risk environments.

Taking these steps can significantly reduce the likelihood of facial injuries and fractures.

Source: CDC - Injury Prevention, WHO - Injury Prevention

Emergency Warning Signs

Seek immediate medical attention if you experience any of the following symptoms after a facial injury. These could indicate a severe complication or a more serious type of fracture:

• Severe or worsening pain: Pain that does not improve with medication or rest.
• Vision changes: Sudden loss of vision, double vision, or inability to move the eye.
• Signs of a skull fracture: Clear fluid draining from the nose or ears (could indicate a cerebrospinal fluid leak).
• Severe bleeding: Uncontrolled bleeding from the nose, mouth, or ears.
• Difficulty breathing: Obstruction of the airway due to swelling or bleeding.
• Loss of consciousness: Fainting or confusion after the injury, which could indicate a head injury.
• Signs of infection: Fever, increased swelling, redness, or pus around the injury site.
• Numbness or weakness: Persistent numbness or inability to move parts of the face, which could indicate nerve damage.

If you or someone else experiences these symptoms, go to the nearest emergency room or call emergency services immediately. Delaying treatment for severe symptoms can lead to long-term complications or permanent damage.

Source: NIH - Emergency Management of Facial Fractures, American College of Emergency Physicians