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Maxillofacial Bone Injuries/Oro-Maxillo-Facial Trauma

Facial fractures or facial trauma are the broken bones of your face. Facial trauma is also termed as maxillofacial trauma. Facial trauma involves soft tissue injuries like burns, lacerations(a deep cut or tear in the skin) and bruises, or fractures of the facial bones like the nose (nasal), cheekbones, around the eyes (orbit) and upper and lower jaws.
Facial injuries can be significant and may lead to loss of function. For instance, a person may become blind or unable to move the jaws. Facial injuries are sometimes deadly and life-threatening because they can cause severe bleeding or obstruct the airway. Depending on the facial injury type and severity, treatment options also vary.

Types Of Facial Fractures or Maxilofacial Bone Injuries

Facial fractures classified into various types based on the location of the fracture on the face.

Frontal bone fractures – Usually, these fractures are caused due to a severe blow to the forehead.
Orbital floor fractures – Traumatic disfigurement of the orbital floor or medial wall. Injury around the eyes.
Nasal fractures – Commonly called a broken nose—these fractures of the nose account for nearly 40% of bone injuries.
Nasoethmoidal fractures – These fractures extend from the nose to involve the bone at the root of your nose(ethmoid bones). A forceful blow on to the central features of the midface results in this fracture.
Maxillary fractures – The two maxillae form the upper jaw including the hard palate in front of the mouth, a part of the nasal cavities, and a part of the orbital cavities. They also form the lower edge of the nasal aperture. Maxillary fractures are classified as:

  • Le Fort I – it is a horizontal fracture that happens across the inferior part of the maxilla
  • Le Fort II- it is a pyramidal-shaped fracture
  • Le Fort III- it is a transverse fracture, also called craniofacial disjunction. It might occur due to a blow to the nasal bridge or upper maxilla.

Mandibular fracture – It is also known as jaw fracture, damage of the mandibular bone. In about 60% of cases, it results in a decreased ability to open the mouth fully.
Alveolar fractures – Alveolar fractures are fractures that happen at the tooth-bearing jaw part. These fractures are often associated with complete or partial displacement of the teeth and/or the jaw.
Pan facial bone fractures – These bone fractures are described as facial fractures involving the upper, middle, and lower part of your face. Fractures of the skull, maxilla, cheekbone, nasoethmoid-orbital region and mandible(lower jaw or jawbone) are the most common.

Causes Of Maxillofacial Injuries

  • Maxillofacial fractures occur as a result of blunt or penetrating trauma.
  • Blunt injuries are common and caused due to vehicular accidents, sports-related injuries, occupational injuries, and falls.
  • Penetrating injuries might be caused due to gunshot injuries, stabbings, and explosions.
  • Injuries due to Animal attacks and industrial accidents at work are some other causes.
  • Nasal fractures are common facial fractures in children, and vehicular trauma is the leading cause of various facial injuries.

Symptoms Of Maxillofacial Injuries

Facial bone fractures are also associated with pain, bruising, and swelling around the tissues. Symptoms may occur even in the absence of fractures as well.

  • Fractures to the nose and the skull, or maxilla might be associated with profuse nosebleeds.
  • Nasal fractures might be connected with damage of the nose, swelling and bruising.
  • Damage in the face, such as sunken cheekbone or teeth that are misaligned indicates the presence of fractures.
  • Asymmetry of the facial fractures indicates the damage to nerves.
  • If the bones in the eye socket are damaged, you may experience symptoms like a black eye, redness or bleeding from the eye, blurry, or decreased eyesight.
  • People with mandibular fractures experience pain and difficulty to open their mouths and might also have numbness in their lips and chin.
  • People with Le Fort fractures, the midface might move near to the rest of the face or alongside the skull.
    Bruising and swelling is the most common symptom of a facial fracture.

Treatment For Maxillofacial Trauma

The treatment options offered for facial injuries depend on the type of fracture, the severity of the fracture or any other problems you may have at the time. The treatment for the injuries might include bandaging and suturing of open injuries, applying ice, antibiotics and pain medication, moving misaligned bones back into place, and surgery.

In general, surgeons treat in a way to bring back the broken bones to realign them (called ‘reducing’ the fracture) and fix them in place, preventing further complications. In some cases, surgeons use plates, screws or wires inside or hardly outside the fracture site to hold the fractured bone in place. Immediate surgery is required if the airway is open and in case of life-threatening conditions.

The main aim of treatment is to repair and restore the face’s natural bony structure and leave no traces of the injury as much as possible. Bone grafting is another surgical option to restore facial bone’s architecture. Grafting helps to fill the missing bone and provide structural support. Expert says that early treatment for facial injuries, within hours or days, gives better outcomes functionally and in appearance as well.

For more information about facial fracture and its treatment, consult our Oral and Maxillofacial surgeons. Our surgeons at Hyderabad Plastic Surgeons clinic are having decades of experience in treating oral and maxillofacial injuries.