Therapy | Zygomatic fracture

Therapy

Depending on the extent of the injuries, zygomatic fractures can be treated either surgically (conservatively) or non-surgically. Patients who have a non-displaced (non-dislocated) zygomatic arch fracture can be treated conservatively in most cases. For these patients it is recommended that physical protection is maintained for a few weeks.

In addition, possible swellings in the area of the face can be treated by careful cooling. However, it should be noted in this context that the coolant should never be applied directly to the skin surface. Ideally, the affected patient wraps a flexible cooling pad with a kitchen towel and places it carefully on the cheek.

In addition, a constant change between cooling and cold free intervals should be maintained. In this way, the swellings are reduced particularly quickly. Surgical treatment is especially necessary if the zygomatic arch fracture has pieces of bone that have slipped out of their original position.

With the help of special plates and screws, the individual bone fragments can be properly rejoined and fixed in their natural position. The operation of the zygomatic fracture is usually performed under general anesthesia. In some cases, however, a surgical procedure can be performed under local anesthesia.

The typical access to the zygomatic bone is through a small skin incision starting from the eyebrow and reaching the lower limb. In rare cases, a surgical access from the oral cavity may be possible. If the bony orbital cavity is also affected (especially the outer rim), a skin incision behind the hairline may be necessary.

During the operation, it is first necessary to return the slipped bone fragments to their natural position. Then the individual fragments are fixed together with the help of small metal plates and special screws. In patients in whom only the actual zygomatic arch is broken, the natural position can be restored using a special hook technique.

The insertion of screws is usually not necessary in these cases. Severe injuries involving the eye socket usually require extensive reconstruction. Depending on the exact location of the fracture lines, additional damage can occur in the area of the vessels.

In these cases, aids such as tamponades or balloons must often be used. Pronounced defects of the bony structures may also make transplantation necessary. In the case of a zygomatic hernia, pieces of bone or cartilage from the ribs or hip are often transplanted in addition to foreign materials. The plates and screws used in a zygomatic fracture can be removed after a healing period of about one year. For this purpose, however, a further operation must be performed.