FACIAL TRAUMAS

 
Introduction
One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye socket, and combinations of these bones. These injuries can affect sight, and the ability to breathe, speak, and swallow. Treatment often requires hospitalization.

Diagnosis
Your doctor will examine you and take a series of x-rays to determine if any bones are fractured. A CT scan may be performed to be sure that no other bones of the face have been fractured. If the blow has been strong enough to break other bones of your face, there also may be damage to your neck and back. Emergency symptoms include an obstructed air passage and profuse bleeding, or both. A jaw fracture is suspected if you are unable to close your mouth, if your teeth are misaligned when your mouth is closed, or if you experience tenderness or numbness around your jaw. An upper jaw that can be moved is a definite sign of fracture. If you are unable to close your jaw, it may be dislocated. Swelling and bruising are likely to accompany all jaw injuries.
Treatment Options
The principles for facial fractures are the same as for a broken arm or a leg. The parts of the bones must be lined up and held in position long enough to permit them time to heal. This may require six or more weeks, depending on the patient's age and the fracture's complexity. When fractures are extensive, multiple incisions to expose the bones and a combination of wiring or plating techniques may be needed. The repositioning technique used by the oral and maxillofacial surgeon depends upon the location and the severity of the fracture. In the case of a break of the upper or lower jaw, metal braces may be fastened to the teeth and rubber bands or wires are used to hold the jaw together. Patients with few or no teeth may need dentures or specially contructed splints to align and secure the fracture.

Recovery Procedures
During the healing period, when jaws are wired shut, the oral and maxillofacial surgeon prescribes a nutritional diet. This helps the injury heal as quickly as possible by keeping the patient in good health. After discharge from the hospital, the doctor gives the patient instructions dealing with continued facial and oral care.