Facial Fractures
Facial fractures are thankfully not a commonplace injury the majority of society will ever experience. They typically require a hefty amount of force from a secondary solid object travelling at speed, and with force and are typically the result of:
- Domestic abuse.
- Assault or Grievous Bodily Harm from an attacker or assailant.
- A sudden blow to the face by a random object. (Storms, bullets, wind gusts, martial arts.)
- Sporting related ‘face plants’ into a hard surface. (Skiing, skating, surfing, horse riding.)
- Motor Vehicle Accidents.
- Miscellaneous causes.
Get Medical Help Immediately For Facial Fractures
You need to see your physician or health care provider for any form of facial fracture, including a broken nose, jaw, cheekbone, or eye socket.
Call 000 if, after receiving a blow to the face, the person:
- Has difficulty breathing.
- The upper and lower jaws don’t meet properly.
- There is an open wound with exposed bone.
- The person has blurred or double vision
- The person has trouble moving their eyeballs.
- The pupils are fixed and dilated.
- The person falls unconscious.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082488/
Control The Pain And Swelling For Facial Fractures
Always keep the person’s face elevated above the heart to allow blood to drain while conscious and breathing naturally.
Apply cold packs, ice packs, or frozen vegetables to reduce and control swelling. The numbness from the cold pack will also help reduce some of the pain the injured person feels.
Call emergency services on 000 in Australia if the person stops breathing and begin the DRSABCD protocol.
Medical Assessment For Facial Fractures
https://www.uptodate.com/contents/initial-evaluation-and-management-of-facial-trauma-in-adults
Epidemiology
Males are more commonly inflicted with facial fractures because they inevitably engage in activities that carry an inherent level of risk or danger that most women do not engage in. Therefore, facial fractures are most commonly received in the third decade of life, i.e., the 20-30 age group.
In females, intimate partner violence and domestic abuse should be considered in patients whose clinical details do not match the fracture, or the injury occurs in the home environment.
The Assessment And Examination
The health care provider will examine the person’s face, head, neck and possibly the upper body. They will order X-rays or other imaging tests, including a CT scan, to see what is occurring under the skin. Some facial fractures go unreported or untreated, and the person isn’t aware they have a hairline fracture. They may simply feel tender in the area for a few weeks before it heals naturally and without intervention or concern.
The health care provider may immobilise broken bones to help them heal. Common immobilisation is for lower jaw fractures where the jaw is wired in place for the time it takes the fracture/s to heal, and then the wire is removed.
Medications will be prescribed to relieve the pain and inflammation and to prevent infection where there are open wounds.
Surgery may be required in some cases to pin, plate, wire, or screw bones that have fragmented and would not repair naturally as they no longer have a blood source and will die and float in their new space. This can cause immune system reactions as the body identifies the dead bone as a foreign body and attempts to break it down and absorb and eliminate it from the body. It is not always successful, and, in some cases, infections can lead to abscesses that require surgery and antibiotics.
If the bones are not correctly aligned, they may repair naturally where they still have a blood supply, but cause deformity in the bone and change the appearance of the face that will require cosmetic surgery, or they are left to live with their new mishappen appearance.
How Long Does A Facial Fracture Take To Heal
Most facial fractures, and fractures in general, will heal themselves over a 3–6-week period where no surgery is required.
If surgery is required, that time might be up 4—8 weeks for a simple break, or longer if the bones were complexly shattered or severed, as in the case of traumatic amputation.
As a general rule of thumb, the medical fraternity will suggest six weeks is enough time for a fracture to have calcified and repaired the break, but that the new bone will still be soft, and care must be taken not to re-fracture or place stress on the break-line for several months as it hardens up over time.
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