Facial Fracture (cont.)
Facial Fracture Medical Treatment
- 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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