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Facial Fracture (cont.)

Facial Fracture Medical Treatment

Nasal fracture

  • First, the doctor will control the nosebleed (if the patient has one). If there is a collection of blood inside the nose, called a septal hematoma, the doctor will drain it by cutting a hole in it to let the blood out.
  • Because the patient's nose will be very swollen at initially, a broken nose is not immediately put back into place (reduced). Even after the swelling improves, reducing a broken nose is necessary only if the patient will have a poor cosmetic result or airflow is obstructed. If it is necessary, a specialist will perform the procedure at a follow-up appointment. By this time, the swelling should have improved, and the bone should be put in place more accurately.
  • Fractures of the bones inside the nose (ethmoid fractures) require hospitalization.

Jaw (mandibular) fracture

  • A broken bone that is visible through the skin or inside the mouth, called an open fracture, requires hospital admission and IV antibiotics.
  • Most of the time, if a patient has a closed fracture of the jaw, he or she will be referred to an oral surgeon for treatment.

Midface (maxillary) fracture

  • Because of the severity of a midface fracture and its associated injuries, the patient may require a tube to be inserted to help them breathe, and the patient will most likely be hospitalized.
  • These fractures usually require surgery. This is usually performed by a plastic surgeon or ear, nose, and throat (ENT) specialist.

Cheekbone (zygomatic) fracture: If the patient's zygomatic arch is fractured, he or she may require surgery to repair it if the fracture is pushed in causing a cosmetic defect.

Eye socket (orbital) fracture

  • The timing of, and need for eye socket fracture repair is controversial.
  • Some specialists feel surgical repair is needed only if the patient has persistent double vision or the eye recedes into the socket.
  • Others use CT scans to help them make the decision. The patient should decide whether to have surgery with the consulting specialist.

Temporomandibular joint dislocation: This is usually realigned in the emergency department. A local anesthetic can be used as well as medication to relax the jaw muscles.

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