Facial bones help protect the brain; house important organs for sight, taste and smell; create the initial passages of the respiratory system; provide the first actions in the digestive process; and are the foundation for communication through facial expressions. Facial trauma can result from a wide variety of blunt and penetrating mechanisms ranging from trivial to life-threatening, including motor vehicle collisions, violent altercations, falls from any height, person-to-person collisions, gunshots and stabbings and falls secondary to seizures.
While in many situations facial trauma only results in lacerations, abrasions or swelling, the results can be significant if it also involves underlying bone structures, injury to the brain leading to intracranial hemorrhage, injury to cervical spine and compromises the airway. Facial bone fractures can be classified in to Mandibular fracture, Lefort fractures, zygomatico-maxillary fracture, Naso-orbito-ethmoidal fracture, Frontal bone fracture or fracture involving multiple facial bones. Primary treatment of the facial injury is to stabilize the critical condition of the patient. Definite treatment to the facial bone fracture should be addressed as early as possible.
Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, and the age and general health of the patient. When an arm or a leg is fractured, a “cast” is often applied to stabilize the bone and allow for proper healing. Since a cast cannot be placed on the face, treatment may involve wiring the jaws together for certain fractures.
However, certain types of fractures of the jaw are best treated and stabilized by the surgical placement of small “plates and screws” at the involved site. This technique is called “rigid fixation” and often allows for healing without having the jaws wired together. The development and use of “rigid fixation” has profoundly improved the recovery period for many patients by allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. Importantly, the patient’s facial appearance should be minimally affected. Access to the facial bones can be through the mouth or are designed to “minimize” or “hide” the incision.
The proper treatment of facial injuries and emergency care is essential for long-term esthetic reconstruction and rehabilitation of the patient.