Child's Cheek Injury: Concerns About Indentation and Hard Lump

Child has a concave injury on the cheek?

A three-year-old child accidentally bumped their left cheek against a table corner, resulting in immediate bruising.
One month later, the bruise disappeared, but there is an approximately two-centimeter oval-shaped indentation on the cheek when smiling.
Above the indentation, there is a three-centimeter elongated hard lump that has been present for over two months.

1.
The area has been massaged daily for about a month, but there has been no improvement.
2.
Will it heal on its own?
3.
If it does not heal on its own, which specialist should be consulted? Could you recommend suitable hospitals in the central region?
Thank you.

Mr. Jiang, 60~69 year old female. Ask Date: 2017/02/24

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to see an orthopedic surgeon to rule out any facial fractures.
Take care! Changhua Hospital cares about you!

Reply Date: 2017/02/24

More Info

When a child experiences a facial injury, such as a bruise or indentation from hitting a hard surface like a table corner, it can be concerning for parents. In your case, your three-year-old child has developed a noticeable indentation on the left cheek and a hard lump after the initial bruise healed. Here’s how to approach this situation:
1. Understanding the Injury: The indentation and hard lump you describe could be a result of several factors. After a blunt trauma, the body may respond with swelling and bruising, which can sometimes lead to changes in the underlying bone or soft tissue. The hard lump could be a callus formation or a bone-related issue, such as a small fracture that did not heal properly.
2. Massage and Healing: You mentioned that you have been massaging the area for about a month without improvement. While gentle massage can sometimes help with soft tissue healing and reduce swelling, it may not be effective for all types of injuries, especially if there is a more significant underlying issue.
3. Natural Resolution: In many cases, minor injuries can resolve on their own, but the timeline can vary significantly depending on the nature of the injury. If the hard lump persists and the indentation does not improve, it is advisable to seek medical attention.
4. When to See a Doctor: If the symptoms do not improve or if you notice any additional symptoms such as pain, changes in skin color, or if the lump increases in size, you should consult a healthcare professional. Given the nature of the injury, it would be wise to see a pediatrician first. They can assess the injury and determine if a referral to a specialist, such as a pediatric orthopedic surgeon or a plastic surgeon, is necessary.

5. Recommended Specialists: In the central region of Taiwan, you can consider visiting hospitals with pediatric departments that specialize in trauma and orthopedic care. Institutions like Taichung Veterans General Hospital or Chung Shan Medical University Hospital have reputable pediatric services.
6. Diagnostic Imaging: Depending on the assessment by the pediatrician, they may recommend imaging studies such as X-rays or a CT scan to evaluate the bone structure and ensure there are no fractures or other underlying issues contributing to the hard lump.

7. Potential Treatments: If the hard lump is determined to be a bone-related issue or a result of improper healing, treatment options may include observation, physical therapy, or, in some cases, surgical intervention to correct any deformities.

In conclusion, while minor facial injuries in children often heal well, persistent symptoms warrant a thorough evaluation. Early intervention can prevent complications and ensure proper healing. It’s always better to err on the side of caution when it comes to your child’s health. If you have any further concerns or if the situation changes, do not hesitate to seek medical advice.

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