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See also trauma to the teeth
What are facial fractures?
Facial fractures are fractures (broken bones) of the face and
mouth. They commonly include fractures of the nose (nasal), cheekbones
(zygoma), surrounds to the eyes (orbit) and upper (maxilla) and
lower (mandible) jaws.
If you have a facial fracture, the oral and maxillofacial team
will usually want to check that you don't have other fractures
of or injuries to the head or neck and if you have been knocked
unconscious.
What causes facial fractures?
Most facial fractures are acute (sudden) and caused by assaults
(eg fighting), sports (eg horse riding, football and rugby) and
accidents (eg road traffic or falls). Rarely, you might get a
fracture following other treatment - sometimes this is because
the bones are weakened by conditions such as dental
cysts.
How will I know if I have a facial fracture?
If you have had some kind of blunt or sharp trauma to your face,
your doctor(s) or dentist(s) will want to check you for facial
and other fractures. They will examine you carefully (looking
for changes in mobility, swelling and pain) but will also send
you for X-rays. Most fractures show up clearly (as dark lines)
on head, facial, jaw and dental X-rays. Some small (hairline)
fractures are more difficult to see and require further X-rays
and followups.
What are treatments for facial fracture?
The treatment options that you will be offered will depend on
the type and extent of the fracture and any other problems you
might have at the time.
In general, doctors will want to bring the broken bones back
into a normal alignment (called 'reducing' the fracture) and keep
it/them in this place (called 'fixing the fracture'), preventing
further injury. Sometimes they will need to operate to do this.
Sometimes they will need to use plates, screws or wires (or other
fixation) inside or occasionally outside the bones to hold the
fractures in place.
Your oral and maxillofacial surgeon will explain more about your
fracture(s) and its treatment.
I have a facial fracture, how long will it take to heal?
How long it takes a facial fracture to heal will depend on the
type and extent of fracture and what other problems and treatment
you had. Bruising and swelling usually takes 2 to 3 weeks to settle
down. At this point, you will begin to look more normal. After
this time the body will continue to heal itself inside. Unfortunately,
you will need to be a patient.
My face is numb or feels odd, after a facial injury, how long
will this take to heal?
The facial bones have many channels in them in which small nerves
run. These nerves are sensory nerves (sensing hot, cold, touch,
pain etc). When the nerves emerge from the bones they distribute
themselves through the soft tissues and skin of the face.
When you have had a facial injury (including a fracture) your
soft tissues, skin and the bones are likely to be bruised, swollen
and damaged. This can lead to short-term pain but also numbness
or altered sensation to the face. Depending on the position and
extent of injury, this change in sensation often takes a number
of weeks or maybe even months to disappear completely. Very occasionally,
only partial or no recovery occurs.
Motor nerves tell muscles how and when to move. They run between
the facial bones and the skin and can be injured by trauma.
What are plates used to treat facial fractures?
The plates used to repair facial fractures are made of titanium.
They hold together and strengthen the bones of your face, head
(or skull) and/or jaws.
Will I have to have the plates removed?
The plates used to repair facial fractures are designed to be
left in place and stay with your bone permanently. Very occasionally,
they might need to be removed later for example if they cause
an infection or discomfort.
Will the plates set off metal detectors at airports?
Because the plates are made of titanium, they do not set off
the metal detectors used at airports.
Do I need to tell anyone that I have a metal plate in my face/jaws?
It is wise to mention your metal plate if you need to have scans
such as computerised tomography (CT) or magnetic resonance imaging
(MRI).
Why have I been told that I shouldn't blow my nose for the
next few days?
If you have a fracture of the cheek bone, you should not blow
your nose for about ten days following the injury. This is because
you might force air from your sinuses into the skin, which can
result in facial swelling around the eyes.
This swelling is temporary and will disappear with time. If you
have any questions, you should seek advice from your oral and
maxillofacial surgeon.
If I have had a facial fracture, what other things should I
avoid for the next few weeks?
If you have had a facial fracture, you will be advised by your
oral and maxillofacial team to avoid knocks or bumps to the area
for at least 6-8 weeks until the fracture has healed. This is
because 'impacts' on fractured areas might move the affected bones.
For how long should I take my antibiotics?
Often we will prescribe a course of antibiotics for people who
have had a facial fracture or other procedure to the mouth or
face. This is to prevent an infection.
Whenever you are prescribed antibiotics, it is important to finish
the course as instructed. This is for your health and also to
prevent the emergence of antibiotic resistance in the general
population.
If you have any problems taking the antibiotics (eg side effects),
do contact your general practitioner (GP) or the oral and maxillofacial
team that treated your injury or performed the procedure.
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