Facial Fracture

What is a facial fracture?

A facial fracture is a break in one or more of the bones in your face. The bones in your face include those around your eye, your cheekbones, and the bones of your nose and jaw. A facial fracture may also cause damage to nearby tissue.


What causes a facial fracture?

A facial fracture may occur when your face has been injured. Motor vehicle, motorcycle, or bicycle accidents can cause injuries that lead to a facial fracture. Facial fractures may also be caused by injuries that occur while playing sports, such as baseball and football. A jaw fracture can also occur if you are hit in the face during a physical attack.

What are the signs and symptoms of a facial fracture?

  • Blurry vision, double vision, or seeing floaters (spots)

  • Decreased eye movement or pain when moving your eyes

  • Eyes that are sunken or not in the normal position

  • Swollen eyelids

  • Bruising on your face

  • Numbness of your upper lip, side of your nose, or cheek

  • Swollen or flattened cheek

How is a facial fracture diagnosed?

Your caregiver will do a complete physical exam. Tell your caregiver about your symptoms and when they started. Your eyesight, pupils, and eye movements will be checked. Your caregiver may use a device to look inside of your eye. Your caregiver will also check your face for skin wounds. You may also need one or more of the following:

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your head. The pictures may show broken bones and damaged tissue and blood vessels. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • Ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to check for damage to your facial bones and tissue.

  • X-rays: An x-ray is a picture of your facial bones and tissue. X-rays may be needed to help your caregiver see your broken facial bones. You may need to have more than one x-ray picture taken.

How is a facial fracture treated?

A facial fracture may be left to heal on its own if your broken bone stays in its normal position. Severe fractures may need to be treated. You may need any of the following:

  • 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 for this procedure. Ask your caregiver for more information about closed reduction.

  • Endoscopy: This test uses a scope to look inside your sinuses and 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. During an endoscopy, small pieces of your broken bone may be removed. Special devices may be used to support the broken bones in your face.

  • Medicines:

    • Decongestant medicine: Decongestants help decrease swelling in your nose and sinuses. This medicine may also help you breathe easier.

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Steroid medicine: This medicine helps decrease swelling in your face.

    • Antibiotic medicine: Antibiotic medicine helps treat an infection caused by bacteria. This medicine may be given if you have an open wound.

  • Orthodontic treatment: You may need to see a caregiver who fixes damaged or broken teeth. Orthodontic treatment may also be done if your teeth do not line up correctly when you close your jaw after your injury.

  • Surgery:

    • Open reduction and internal fixation: This surgery is also called ORIF. During an ORIF, your caregiver makes an incision over your fracture site. Wires, screws, or plates are used to join your broken facial bones together. This surgery helps keep the bones 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 bone taken from another area of your body or from a donor (another person).

How can I care for myself at home?

  • Apply ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your face for 15 to 20 minutes every hour as directed.

  • Keep your head elevated: Keep you head above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your head on pillows or blankets to keep it elevated comfortably.

  • Avoid putting pressure on your face:

    • Do not sleep on the injured side of your face. Pressure on the area of your injury may cause further damage.

    • Sneeze with your mouth open to decrease pressure on your broken facial bones. Too much pressure from a sneeze may cause your broken bones to move and cause more damage.

    • Try not to blow your nose because it may cause more damage if you have a fracture near your eye. The pressure from blowing your nose may pinch the nerve of your eye and cause permanent damage.

  • Clean your mouth carefully: It may be hard to clean your teeth if have an injury or fracture near your mouth. Your caregiver will show you the best way to do this so you do not hurt yourself. A water pick or a child-sized soft toothbrush may work well to clean your mouth.

What are the risks of a facial fracture?

  • Treatments may lead to swelling, pain, bruising, bleeding, and infection. You may have scarring and hair loss from surgery. Treatment may damage nearby tissue and nerves, causing numbness. Surgery may also damage your sinuses and cause them to swell. Even with surgery, you may have uneven facial features, bulging eyes, vision changes, and permanent blindness. Bone and tissue grafts may move out of place and require 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. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

  • 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 have bleeding in your brain, which can lead to seizures and be life-threatening.

How can I help prevent a facial fracture?

  • Wear a helmet when you ride a bicycle or a motorcycle.

  • Wear a seatbelt at all times when you are inside a motor vehicle.

  • Wear protective headgear and eyewear during sporting activities.

When should I contact my caregiver?

Contact your caregiver if:

  • You are bleeding from a wound on your face.

  • You have double vision or you suddenly have problems with your eyesight.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have clear or pinkish fluid draining from your nose or mouth.

  • You have numbness in your face.

  • You have worsening pain in your eye or face.

  • You suddenly have trouble chewing or swallowing.

  • You suddenly feel lightheaded and short of breath.

  • You have chest pain when you take a deep breath or cough. You may cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

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. 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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