How to treat a facial bone fracture?

Causes of damage to the maxillofacial area

People are injured during traffic accidents, blows, falls. In a road accident, an unseated person in the back seat most often suffers: he hits his face and breaks the bones of his facial skull. Moreover, such fractures are complex, the bone breaks into 10-15 fragments and it has to be reassembled. In the warm season, scooters and bicycles create an additional danger: with sharp braking, a person suddenly flies forward and meets an obstacle face-on. Depending on the angle of fall and the type of obstacle, people end up breaking the cheek-orbital complex, jaw, chin or nose.

Classification of facial bone fractures

Fractures of facial bones can be closed or open. With an open fracture, the soft tissues of the face are also damaged: for example, a cleft chin, brow bone, surface tissues of the nose, upper and/or lower lip. The following types of facial bone fractures are distinguished:

• fracture of the upper jaw (according to the height of the impact, it is classified according to the Le Faure system);
• fracture of the zygomatic-orbital complex;
• fracture of the lower jaw;
• fracture of the nose or bridge of the nose;
• fracture of the temporal bone;
• fracture of the zygomatic bone of the face.

A fracture of the facial bones can be complex and combined with injuries to the skull and brain. Therefore, the patient also needs the consultation of a neurosurgeon.

What symptoms indicate a facial bone fracture?

A fracture of the facial bones is primarily indicated by the appearance of asymmetry. The bones of the facial skull support the soft tissues of the face, and a displacement of even two to three millimeters objectively falls into the eye. The first hour or two after the fracture, the affected side seems to sink inward, then a large swelling develops. Other symptoms of facial bone fracture depend on its type:

• with a fracture of the lower jaw, pain occurs when trying to move the jaw, a person hears the crunch of fragments;
• with a fracture of the cheekbone or the cheekbone-orbital complex, there may be no sharp pain, but a part of the face becomes numb;
• with a fracture of the upper jaw of medium and high Le Fort part of the jaw can move independently of the rest of the skull;
• with a broken nose, the nose crunches after the blow, hematomas around the eyes and difficulties with nasal breathing occur.

The patient will have the best chance of recovery if the surgical treatment of the fracture of the facial bones is carried out within the first 24 hours after the injury. During the operation, in six months to a year, the bone will have to be cut and collected again, so it is much more difficult to restore the previous appearance and restore the symmetry of the patient’s face.

How is a maxillofacial fracture diagnosed?

In case of facial bone injury, you should consult a maxillofacial surgeon for diagnosis and treatment. He will prescribe a computer tomography, which will help distinguish a fracture from a severe bruise of the cheekbone, jaw or nose. At the Sirius Dent Medical Center, it is possible to urgently perform a CT scan and receive a conclusion in a few minutes.

Can a facial bone fracture be cured at home?

Treating facial bone fractures at home is notoriously a bad idea, because when a bone is broken into several fragments, they must be put back in place and fixed. This is done in the operating room, not at home. If the bone fragments grow incorrectly, this will lead to irreparable consequences: from disfigurement and permanent paresis of the face to chronic sinusitis after a fracture of the maxillary sinus.

Methods of treatment of facial bone fracture

Fractures of the jaw and other facial bones are treated in the Sirius Dent Medical Center without splinting, but with a more gentle method of metallo-osteosynthesis. For each area of ​​the face, titanium plates of different shapes, configurations, and thicknesses are used. Moreover, with the help of computer technology, we can manufacture titanium plates individually. First, the maxillofacial surgeon correctly places the patient’s bone fragments virtually in the program, and then models such a plate that will fit tightly to the surface and manufactures (prints) it from titanium. Then installs it during the operation.

Bruises and fractures of facial bones in children often do not require surgical treatment. The bones of a child differ from those of an adult in terms of chemical composition, and it is much more difficult to break them. These are not comminuted fractures, but cracks that heal successfully without surgery. However, in case of injuries to the soft tissues of the child’s face, it is necessary to apply neat plastic sutures in order not only to close the edges of the wound, but also to avoid the formation of scars. In general, we at the Sirius Dent Medical Center often use plastic approaches and sutures, because the aesthetic result plays a significant role in facial injuries. And during the extraction of titanium plates, we can sometimes carry out additional plastic interventions (for example, correction of the shape of the nose and nasal septum).

How is the recovery after a maxillofacial injury?

The duration of the recovery period depends on the nature of the injury. So, in the case of soft tissue damage, a person wears a bandage for several days, after which the stitches are removed, and the treatment ends there. With more complex injuries in the postoperative period, she may have hematomas and swellings that go away for one and a half to two weeks.

Paradoxically, a fracture of the maxillo-orbital complex, which is more difficult to treat, has an easier recovery period: the patient just needs to protect his face and lead a calm lifestyle without excessive physical activity (gyms, running, crossfit). However, with a fractured jaw, you will have to wear braces that tightly bind the teeth together for a few more weeks, and eat ground food through a tube.

Complications of maxillofacial injuries

Complications of maxillofacial injuries also depend on what exactly was broken. In any case, with a displaced fracture, the shape of the bony support changes and facial asymmetry and distortion occur. If it is a fracture of the lower wall of the orbit, the complication will be enophthalmos (“slipping” of the eye into the maxillary sinus) and persistent vision impairment up to its loss. With a fracture of the articular process of the lower jaw, there is a violation of the bite, blocks of chewing amplitude. That is, a person cannot open his mouth and chew. And if the wall of the maxillary sinus is broken, bone fragments get inside and a hematoma is formed, and sinusitis occurs, which later turns into a chronic form.