Facial Fracture

WHAT YOU SHOULD KNOW:

• A facial fracture is a condition when one or more bones in your face are broken. Your face is made up of many bones connected to each other. These include the bones of your orbit (around your eye), zygoma (cheekbones), nose, and jaw. These bones may be broken when you have an injury to your face. A break in one or more of your facial bones may also cause damage to your nearby tissue. The muscles or nerve around your eyeball may also get pinched in between these fractures.
  
  
• Facial fractures may be caused by work or sporting accidents, traffic accidents, an assault, or fall. You may have bleeding, bruising, scrapes, or numbness in the injured area of your face. You may also have trouble seeing or have double vision. A computed tomography (CT) scan, ultrasound, and x-rays of your face may be needed. Treatment may include medicines, an endoscopy, or surgery to fix your broken facial bones. Having your facial fracture treated may resolve your swelling and pain. Treatment may also fix your broken facial bones and save your life.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Medicines used to treat a facial fracture may cause an allergic response. Treatments may lead to swelling, pain, bruising, bleeding, and infection. You may have scarring and hair loss from surgery. Treatment may damage your nearby tissue and nerves causing numbness. Surgery may also damage your frontal sinuses (air-filled spaces in your skull) and cause them to swell. The membranes covering your brain and spine may also be damaged leading to swelling and infection. Even with surgery you may have uneven facial features, bulging eyes, and vision changes including permanent blindness. Bone and tissue grafts may move out of place requiring another surgery. Plates and screws used to fix your bones may become infected or need to be replaced.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• Without treatment, your facial fracture may lead to uneven facial features, facial pain, eye pain, or blindness. You may have bleeding that blocks your airway making it hard to breathe. You may also bleed into your brain leading to seizures (convulsions), and you may die. Talk to your caregiver if you have questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Diet:

You may not be able to eat solid food for a period of time. You may first be started on a liquid diet. Examples of liquids include, water, broth, apple juice, or lemon-lime soda pop. You may also be able to suck on ice chips or eat gelatin. After a few days, you may be allowed to eat soft foods. Some examples are applesauce, baby food, bananas, cooked cereal, cottage cheese, eggs, gelatin, pudding, and yogurt.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Oxygen

You may need extra oxygen to help you breathe easier. Oxygen may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you.

Medicines:

You may be given the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Decongestant medicine: Your caregiver may give you decongestants to decrease swelling in your nose and sinuses (air filled spaces). Decongestant medicine may also help you breathe easier.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Steroids: This medicine may be given to decrease inflammation.
  
  
• Tetanus shot: If you have an open wound from your injury, you may need a tetanus shot. Tetanus bacteria can enter your body through a wound and make you very sick. A tetanus shot is medicine to help prevent you from getting the bacteria. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm may become red, swollen, and sore after getting this shot.

Monitoring:

• Neurological signs: Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your eyes, your memory, and how easily you wake up. Your hand grasp and balance may also be tested. This helps tell caregivers how your brain is working after an injury. You may need to have your neuro signs checked often. Your caregiver may even have to wake you up to check your neuro signs.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Tests:

• Eye exam: An eye test may be done to check your eyesight. You may also need an eye exam to check the nerves and tissue of your eyes for damage.
  
  
• Imaging tests: Certain tests use a special dye to help pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies.
  
  
  • Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your head. This test may be done after surgery to check if your broken bones are in the proper position.
    
    
  • Magnetic resonance imaging: This is also called an MRI. An MRI shows pictures of the inside of your head. This test may also help your caregiver see if your broken bones were put in the proper position. You will need to relax and lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

Treatment options:

Cold packs may be placed on your face to prevent further swelling. If you have a broken nose, direct pressure may help stop any bleeding. A nasal packing placed inside your nose may also help prevent further bleeding. You may also need any of the following treatments for your facial fracture:

• Closed reduction: During this procedure, your caregiver moves your broken bones back to their normal position. Closed reduction is often done when you have a broken nose. You will not need an incision (cut) for this procedure. Ask your caregiver for more information about closed reduction.
  
  
• Endoscopy: This test uses a scope to look inside your sinuses and orbital cavity (eye socket). The scope is a long tube with a lens and light on the end. The scope is placed between your upper gums and lip and into the sinus behind your cheekbone. The scope may also be put through a small incision in your scalp and into the sinus behind your forehead. The scope may help your caregiver see your facial fracture better. During an endoscopy, small pieces of your broken bone may be removed. Special devices may be placed to support the broken bones in your face.
  
  
• Surgery:
  
  
  • Open reduction and internal fixation: This surgery is also called ORIF. During an ORIF, your caregiver makes an incision over your fracture site to look at your broken bones. Special wires, screws, or plates may be used to join your broken facial bones together. This surgery is done to hold your bones in place and keep them from moving while they heal.
    
    
  • Reconstructive surgery: Reconstructive surgery may be needed to fix areas of your face that are misshapen by your injury. Your caregiver may need to remove pieces of your broken facial bones and replace them with a graft. A graft is healthy tissue taken from another area of your body or from a donor (another person).

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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.

Learn more about Facial Fracture (Inpatient Care)