Synonym
Fracture of the zygomatic boneA zygomatic bone fracture is a fracture of the bony zygomatic bone. The zygomatic bone is a bone that lies next to and below the orbit in the area of the upper half of the cheek. The presence of a zygomatic bone fracture can often be observed, especially in athletes.
The bony zygomatic bone is a paired bone that forms the outer boundary of the orbit. From an anatomical point of view, the zygomatic bone is counted among the so-called facial skull bones. From the outside, the bone can be palpated in the upper part of the cheek. In most cases, coarse force can lead to a fracture of the zygomatic bone. For the patients concerned, such a fracture of a facial skull bone can be extremely painful.
Causes
The main cause for the occurrence of a zygomatic fracture is a direct, strong, mechanical violent impact on the zygomatic bone. Possible accident mechanisms can be a collision, a fall or a punch. The zygomatic bone fracture is particularly common in footballers, following a collision between two players.
In addition, a zygomatic bone fracture often occurs in the course of bicycle or traffic accidents. Other possible causes for the occurrence of a zygomatic fracture are physical confrontations such as brawls. Depending on the cause and the course of the accident, the zygomatic bone fracture can take on different forms.
In particular, the exact location and the resulting bone parts differ greatly depending on the cause. In addition, other bony structures can be affected in the course of physical confrontations or traffic accidents. The zygomatic bone fracture often occurs in connection with fractures of the nasal bone or the eye socket.
Symptoms
Since a zygomatic fracture can occur at different locations of the bone, the symptoms can also differ significantly depending on the exact location. Typically, the fracture line runs from the inner eye socket to the wall of the maxillary sinus and through the actual zygomatic arch. In many cases, the zygomatic arch fracture occurs in combination with other bone fractures in the area of the facial skull.
The typical symptoms of a zygomatic arch fracture include swelling and bruising in the upper part of the cheeks. In addition, the zygomatic hernia often results in hematomas in the area of the eye (see also: Bruising in the eye). If a zygomatic bone is fractured, these bruises only occur in one eye.
In this case, it is called a monocular hematoma. A cheekbone fracture is described as extremely painful. The cause is usually an extremely strong violent impact on the zygomatic bone.
Patients feel a strong, intense pain already at the moment of impact. This pain often increases in intensity in the course of the treatment. In most cases, the pain is not limited to the fracture site, but spreads into the surrounding area by infiltrating it.
Patients describe a radiating pain that spreads from the crown of the head over the entire face to the lower jaw bone. Even slight movements of the facial musculature can trigger extreme pain reactions, so that the patients are dependent on a well-acting analgesia. Due to the radiating pain, eating is often not possible in the first few days, as even slight chewing movements can be painful.
The sensation of pain is further supported and intensified by the swelling and bruising that develops, especially in the upper cheek area and around the eyes. Here, haematomas are formed by bleeding into the damaged tissue, which are extremely sensitive to pressure. The violent impact often causes bleeding, which is also perceived as very unpleasant.
On the one hand, the patients bleed from the nose, but bleeding into the maxillary sinus can also occur. Also not pleasant for the patients are the impairments of vision caused by hematomas on the eyes. Usually these are not described as painful, but due to the occurrence of double vision and the blurred vision that can occur, patients are very limited in the perception of their surroundings.
Large hematomas can also be very painful under pressure and limit the mobility of the eyeball. It is important to adjust the acute pain well with the help of an appropriate analgesia, so that further treatment of the fracture, either conservative or surgical, can be sought.Patients who have a zygomatic fracture usually describe severe pain that can radiate almost over the entire affected half of the face. In addition, many of the affected patients have bleeding from the maxillary sinus.
These bleedings become noticeable by the occurrence of strong nosebleeds. Another typical symptom of a zygomatic fracture is a conspicuous flattening of the face. The reason for this flattening is usually a change in position (dislocation) of one or more bone fragments.
However, this symptom of zygomatic fracture can easily be overlooked in patients with severe swelling. In many of the affected patients, a pronounced asymmetry of the facial skull can also be observed. In addition, in the case of a zygomatic fracture, clear steps can often be palpated along the natural course of the bone.
Triggered by possible changes in the position of the bone fragments, severe swelling or hematomas, the patient’s eye movement may be significantly restricted. In the clinical course, this limitation is particularly noticeable through the perception of double images. Since structures in the immediate vicinity of the bone are often damaged in the course of a zygomatic fracture, sensitivity disorders can also occur. In the case of injury to the maxillary nerve, these sensitivity disturbances are particularly noticeable in the cheek area. If direct force is applied to the eyes, damage in the form of visual deterioration (blurred vision) can be observed.
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