There are several types of facial fractures:
Orbital fractures: can be isolated or occur with more extensive facial injury. These fractures are often a result of direct trauma from the front such as trauma from a first or a ball. Not all orbital fractures need surgical intervention please see Dr. Christine Blaine if you have any question. Surgery is recommended if:
- Your vision is compromised
- The eyeball has sagged into the socket causing a sunken appearance
Repairs usually take place approximately 1-2 weeks after the injury because swelling will have reduced by then. Incisions vary but can be placed just inside the eyelid to be hidden. The fracture is reduced, or shifted back into its normal position as best as possible, and the broken bones are often supported with a titanium plate or other similar material.
Nasoethmoid complex fractures: usually the result of high velocity trauma. Due to the proximity of the ethmoid sinuses to the skull base, sometimes patients can have leakage of cerebral spinal fluid (CSF), or the fluid that bathes in the brain and spinal cord, with these injuries.
Surgical repair is conducted to re-approximate the proper distance between the eyes. This can involve plating and wiring of the fractured bones.
Maxillary fractures: involve the mid-face. They are usually the result of high-speed trauma, i.e. motor vehicle accidents.
The goal of surgery is to restore the normal contour of the facial skeleton and to ensure that a patient’s jaw or bite functions as normally as possible. Many techniques can be used to access the fractures and may include incisions through the mouth or gums or in more extensive fractures, incisions in the hairline. Once fractured bones are moved back into place and stabilized, plates and screws can be utilized to keep the bones from moving again.
Mandible fractures: second most common fractures in facial trauma, often times the jaw is fractured in not just one but two places. The ideal time to repair jaw fractures is 7-10 days after the injury.
Treatment options depend on the individual and the extent of the fracture. The goal of surgery is to re-approximate the teeth to the pre-injury position. This may involve maxillomandibular fixation (MMF), which fixes the upper teeth to the lower teeth for an extended period of time while the fracture heals. Patients must maintain a diet of liquids only during this time. Other options include open rigid fixation, which involves stabilizing the fracture with titanium plates and screws. The incisions can be made either through the mouth or hidden in a jaw or neck crease.For more information please contact Dr. Christine Blaine.