Facial Fracture In Children

What is a facial fracture?

A facial fracture (FRAK-chur) occurs when one or more of your child's bones in his face are broken. The bones of the face add shape and protect the brain against injury. These bones also contain and protect the teeth and sense organs of smell, sight, and taste. The facial bones include the cheekbones and the bones around the eyes, nose, and mouth. Facial fractures often affect children in ages between 1 and 4 years. There is usually a peak during summer and spring seasons. With proper treatment, care and follow-up, your child has a greater chance of having a full recovery.

What causes a facial fracture?

A facial fracture in children is usually caused by injury or trauma to the face. This usually happens when a child falls from a height and lands on his head or face first. He may have fallen from the bed or down the stairs. Most injuries occur while the child is playing. A direct blow to the face may also cause a facial fracture. This may occur during a fight, physical abuse, car accident, or in contact sports.

What are the signs and symptoms of a facial fracture?

Signs and symptoms may depend on what part of the face is injured. Your child may have one or more of the following:

  • Cut, bruise, swelling, or bleeding on his face.

  • Face that is deformed.

  • Feeling of tingling or numbness.

  • Headache, or pain on his face.

  • Nausea (upset stomach) or vomiting (throwing up).

  • Problems with seeing, such as seeing double or limited eye movements.

  • Trouble breathing, talking, or biting.

How is a facial fracture diagnosed?

Your child may need one or more of the following:

  • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your child's face and head. It may be used to look at your child's bones, muscles, and brain. Your child may be given a dye before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your child's caregiver if he is allergic to shellfish, or has other allergies or medical conditions.

  • Magnetic resonance imaging scan: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your child's face and head. During an MRI, pictures are taken of his bones, brain, or blood vessels. He will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.

  • X-rays: Your child may need to have x-rays of his face and head taken to check for broken bones or other problems.

How is a facial fracture treated?

Treatment will depend on the damage and the type of fracture your child has. Most facial fractures heal more rapidly among children than in adults. The younger your child is, the faster the fracture will heal without further problems. Your child may also need any of the following:

  • Device: Your child may need to wear a brace to keep his neck from moving. This may prevent more problems if his spine is injured. Bandages, wires, or splints may also be used to support your child's facial bones.

  • Irrigation and debridement: This is done when the facial fracture has an open wound. This cleans and removes objects, dirt, or dead tissues from the fracture area.

  • Medicines: Caregivers may give your child medicine to help ease his pain. Your child may need antibiotic medicine or a tetanus shot if the bone has broken through his skin.

  • Surgery: Your child may need surgery to return the bones to their normal position if the fracture is bad. Surgery may also be needed to correct a deformity or fix damaged tissues on the face. Pins, plates, and screws may be used to hold broken bones together. Damage to the eyes, nose, mouth, nerves, or blood vessels may also be treated with surgery.

What is the first-aid for a facial trauma?

You may do the following if your child had a facial trauma:

  • Check to see if your child is breathing or has a pulse. Start rescue breathing and CPR (basic life support) if needed. Have someone call 911 or a hospital for medical assistance.

  • Do not move your child until there is medical help available. If your child is vomiting and needs to turn on his side, make his head and neck stable. Do this by holding both sides of his head and shoulders. Do not allow his head to bend forward or backward, or to twist or turn.

  • Do not pour any liquid into your child's mouth or offer food or medicines until he is fully awake.

  • Do not remove or pull anything that is sticking out from his face.

  • If your child's face is bleeding, apply direct pressure on the wound using a clean cloth. Place another cloth on top of the original cloth if it gets soaked with too much blood.

  • If your child is having a seizure (convulsion), stay with him until the seizure ends. Let him rest until he is fully awake.

How can a facial fracture be prevented?

  • Always put your child in a car safety seat in the back seat. Do not start the car until your child's seat belt is fastened. If your child is old enough, have him wear a seat belt properly when driving or riding in a car.

  • Do not leave your baby alone on the bed, changing table, or couch. Place him in a crib or playpen if you must leave him unattended.

  • Do not let your child dive in a shallow pool area or in water where the depth is not known.

  • Make sure your child wears proper padding and protective gear when playing sports. These include helmets, mouth guards, wrist guards, or kneepads that meet safety standards. Teach your child about following safety regulations. Ask your child's caregiver for more information about bicycle helmet safety.

Where can I find support or more information?

A facial fracture is a life-changing injury for your child and your family. Accepting that your child has a facial fracture may be hard. You, your child, and those close to you may feel sad, angry, depressed, or frightened. These are normal feelings. Talk to your child's caregivers, your family, or friends about your feelings. You may also want to join a support group. This is a group of people who had head injuries or had a facial fracture. Ask your caregiver for information about support groups.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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