Facial Fracture Repair
Facial fractures can occur as part of general injuries in high-energy trauma such as traffic accidents, work accidents and falls from a height, or on their own after simpler trauma such as a punch. Depending on their location, fractures of the face can impair vision, chewing and speech, cause sunken areas that affect appearance, and cause numbness due to nerve damage. For this reason, they should be repaired once the patient’s general condition allows. If the injury has caused other problems, these are treated first; facial fracture treatment is carried out once the patient is out of danger.
Which Bones Are in the Face?
The lower and upper jaw bones, the nasal bone and the cheekbone are the most noticeable bones of the face. Together with the bones of the skull, the facial bones form the eye sockets, the jaw joint and the floor of the nose. The nerves and blood vessels of the face pass through grooves and openings in these bones.
Which bone is most often affected in facial fractures?
In facial trauma, fractures of the lower jaw are the most common. However, many patients with a broken nose let it heal on its own without going to hospital, so nasal fractures are probably even more common.
The nasal bone, the angle of the lower jaw and the part extending to the jaw joint, and the floor of the eye socket are the weak parts of the face, so they can break even in low-energy trauma. Depending on the severity of the trauma, several bones may break at the same time.
How are facial fractures diagnosed?
In facial fractures, the patient’s general condition is evaluated first. If there are other life-threatening injuries, these are treated first. A general examination of the face is done, and any cuts that may accompany the fractures are assessed. Vision and eye movements are evaluated, and jaw movements and facial expressions are checked. The face is checked for any loss of sensation. A fracture can usually be detected by physical examination. To confirm the diagnosis, the facial bones are evaluated with X-ray or CT scan.
How are facial fractures treated?
Before treating facial fractures, the patient’s general condition must have fully recovered and be stable enough for surgery. Sometimes, in patients whose general condition is good, surgery may be planned after the swelling goes down if the area around the eyes or inside the mouth is very swollen. To reach the broken bones, incisions are made along the lower eyelash line, within the hairline or under the eyebrow for fractures around the eye, and inside the mouth or at the angle of the jaw for jaw fractures. The fractures are fixed with titanium plates and screws. In fractures of the lower or upper jaw, the two jaws can be tied together with wires attached to the gums. In some jaw fractures, this treatment, called intermaxillary fixation, may be enough on its own. Treatment varies according to the location, size and type of the fracture.
What is recovery like after facial fractures?
After surgery for fractures around the eye, the eye may be kept closed for two days if needed. For jaw fractures, you eat liquid and soft foods until healing is complete. The swelling in the face goes down within one to two weeks, but full healing of the bones can take a few months.
What problems can occur after facial fractures?
With some facial fractures, numbness in the cheek may occur and may continue after surgery. There may be swelling in the face. Jaw function may be limited. Infection related to the plates may develop.
Information and Booking
If, after a blow to the face, you have a deformity of the face, difficulty chewing or opening and closing your mouth, double vision or numbness in the cheek, you should be evaluated for a facial fracture. After an accident or serious injury, it is important to go to the nearest emergency department first. Once the emergency has passed, we can evaluate together at the consultation the repair of the fracture, or a sunken area or asymmetry left by a fracture that has already healed. If you have them, bringing your X-ray and CT images and reports to the consultation makes the evaluation easier.