The zygomatic bone, commonly known as the cheekbone, is a prominent and structurally significant part of the mid-face. A fracture to this complex is a frequent facial injury, often resulting from direct trauma like accidents or falls. Whether a broken cheekbone can heal itself depends entirely on the nature and severity of the break. The treatment path and outcome are determined by how the bone fragments are aligned and whether they affect surrounding structures.
Factors Determining Fracture Severity
Medical professionals assess several criteria to classify a zygomatic fracture and determine the appropriate treatment approach. The most fundamental distinction is between a non-displaced and a displaced fracture, referring to the alignment of the bone pieces. Non-displaced fractures are stable, meaning the bone fragments remain in or near their correct anatomical position. Displaced fractures, however, involve a significant shift in the bone fragments, often caused by the initial force of impact or the pulling action of attached muscles.
Functional impact is a major factor, as the zygomatic bone forms part of the orbit, or eye socket. Fractures interfering with eye function, such as causing double vision (diplopia) or sinking of the eyeball (enophthalmos), indicate a more severe injury. Nerve involvement is also assessed, particularly for the infraorbital nerve, which can lead to numbness or tingling in the cheek, upper lip, and gums. Interference with the temporalis muscle can restrict jaw movement, a condition known as trismus, which necessitates intervention.
Diagnosis relies on a thorough physical examination combined with detailed imaging, such as a Computed Tomography (CT) scan. The CT scan provides a three-dimensional view, allowing doctors to precisely measure the degree of displacement and identify any damage to the delicate structures of the orbital floor. This assessment of displacement, functional impairment, and associated nerve or orbital injury dictates whether the body can safely heal the injury naturally or if surgical intervention is required.
Non-Surgical Treatment and Healing
A broken cheekbone can heal without surgery, but this is reserved for specific types of injuries. Non-surgical management is recommended for fractures that are minimally displaced, stable, and do not cause significant functional or cosmetic issues. The primary goal of treatment is to support the body’s natural regenerative process while preventing further displacement of the bone fragments.
The body heals a fracture by forming a bridge of new bone tissue, known as a callus, across the break. This process requires the bone pieces to be held steady and in good alignment for the new tissue to harden correctly. Conservative management involves a period of significant rest, strict dietary modifications to avoid heavy chewing, and avoiding any pressure on the injured side of the face. Patients are often advised to consume only soft foods for four to six weeks to minimize movement from the attached chewing muscles.
Close follow-up is necessary to ensure the fracture remains stable and does not shift as the initial swelling subsides. Monitoring often includes repeat physical examinations and follow-up imaging to confirm the bone is healing in the proper alignment. If the fracture is allowed to heal in a poor position, it can lead to long-term facial asymmetry or persistent functional problems.
When Surgical Repair is Necessary
Surgical repair is necessary when the fracture is significantly displaced, unstable, or causes impairment of function or noticeable cosmetic deformity. Functional problems compelling surgery include:
- Double vision.
- Restricted jaw opening.
- Persistent numbness from infraorbital nerve entrapment.
- Severe displacement resulting in visible flattening of the cheek contour.
The most common surgical approach is Open Reduction and Internal Fixation (ORIF). This involves surgically exposing the fracture sites to restore the bone to its original anatomical position. Once correctly aligned, the bone fragments are secured using small, medical-grade titanium plates and screws. This internal fixation acts as scaffolding to hold the reduction stable during healing and prevents powerful chewing muscles from pulling the bone segments out of place.
Surgical intervention is generally timed to occur after the initial severe swelling has gone down, often within seven to fourteen days of the injury. Operating too early can be technically challenging due to tissue distortion, while waiting too long risks the bone fragments beginning to set in a misaligned position. The goal of the procedure is to re-establish the three-dimensional integrity of the mid-face skeleton, which supports the globe of the eye and maintains facial symmetry.
Recovery Timeline and Post-Treatment Care
The initial healing phase for a broken cheekbone, whether treated surgically or non-surgically, generally takes about four to six weeks for the bone to achieve sufficient stability. During this time, the newly formed callus matures and hardens, allowing the bone to withstand minor stresses. Full recovery, where the bone is completely consolidated and symptoms have largely resolved, often ranges from three to six months.
Post-treatment care involves strict adherence to physical restrictions to protect the healing bone. Patients must avoid contact sports and any activity that risks a blow to the face for a minimum of three months. A soft diet is maintained for the initial weeks to avoid placing stress on the jaw and cheekbone from chewing. For fractures involving the orbital area, it is advised to avoid blowing the nose for several weeks to prevent air from being forced into the surrounding tissues.
Potential long-term issues include the possibility of persistent numbness in the distribution of the infraorbital nerve, though this often improves over many months. Some patients may also experience subtle facial asymmetry that was not fully corrected or a slight depression at the fracture site. Regular follow-up appointments are therefore necessary to monitor the healing progress, manage any lingering symptoms, and ensure the long-term functional and aesthetic outcome is successful.