Facial Fractures

What are facial fractures?

Facial fractures refer to broken bones in your face. This type of facial trauma (also called maxillofacial trauma) can happen if you’re involved in an accident, such as a car crash or fall. Facial fractures are also common among victims of physical assault and gunshot wounds. Your facial bones are thinner than a lot of other bones in your body, making them prone to injury.

Types of facial fractures

The most common facial fractures include:

• Nasal fractures (broken nose).
• Forehead fractures (broken frontal bone).
• Orbital fractures (eye sockets).
• Zygomatic fractures (cheekbones).
• Tripod facial fracture (involving your eye socket, cheekbone and upper jaw).
• Maxillary or mandibular fracture (broken jaw).
• Mid-face fractures (Le Fort fractures).

What are the symptoms of a facial fracture?

Facial fracture symptoms depend on which area of your face has trauma.

General symptoms may include:

• Bruising.
• Swelling.
• Pain or tenderness.
• Facial numbness.
• Disfigurement.

If you have a broken nose, you may have:

• Difficulty breathing through your nose.
• Nosebleeds.

If you have fractured eye sockets, you may develop:

• Blurred vision.
• Double vision.
• Bulging eyeballs.
• Sunken eyeballs.
• Difficulty moving your eyes up, down or back and forth.

Fractured jaw symptoms may include:

• Drooling.
• Difficulty chewing or speaking.
• Pain when opening your mouth.
• Loose, broken or missing teeth.

What causes facial bone fractures?

The most common cause of facial fractures is physical assault, followed by vehicular accidents and falls. Other causes include:

• Sports-related injuries.
• Workplace accidents.
• Domestic violence.

What are the complications of facial fractures?

Facial bone fractures can distort your appearance and interfere with normal function. For example, a person with a jaw fracture will have difficulty eating. Someone with a nasal fracture may have trouble breathing through their nose.

Facial trauma can also result in infections, internal bleeding and neurological issues. For instance, some facial bone fractures can cause a cerebrospinal fluid (CSF) leak.

To reduce your risk of complications, you should see a healthcare provider immediately following facial trauma.

How are facial fractures diagnosed?

During a visit with a healthcare provider, they’ll:

• Determine if you have any life-threatening injuries. (If you do, they’ll address them right away.)
• Check your nasal passages and airways for obstruction.
• Look at your eyes to see if they’re functioning properly.
• Check for damage to your central nervous system (your brain and spinal cord).
• Ask you to describe your symptoms.
• Ask about your facial injury and how it occurred.
• Check your face for asymmetry or damage.
• Gently palpate (press on) the bones of your face to determine the extent of damage.

What tests help diagnose facial fractures?

Imaging tests help healthcare providers diagnose facial fractures and rule out other issues like dislocation. Computed tomography (CT) is the most common imaging test used for diagnosing facial fractures.

How are facial fractures treated?

Your healthcare provider may prescribe pain relievers as well as corticosteroids to ease swelling. They may also prescribe antibiotics if there’s a high risk of infection.

Facial fracture treatment involves reduction and fixation.

• Reduction: resetting the broken bones and placing them in their correct positions.
• Fixation: keeping the bones in their new positions long enough for healing to take place. This usually requires keeping the affected bones still and preventing movement during recovery. Sometimes this requires surgical plates, screws and wires.

For a complex fracture with multiple broken bones, you’ll need facial reconstructive surgery. Specific treatment depends on the location and extent of your facial injury.

Closed reduction

Closed reduction involves resetting fractured bones without surgery. This means your provider can manually reset your facial bones without making incisions (cuts) or exposing your bone.

Open reduction

Open reduction involves surgical intervention. In these cases, the fractures are too complex for manual resetting. A provider will need to explore the area surgically to reset your facial bones.

Facial reconstructive surgery

Severe facial trauma may require reconstructive surgery. There are two main goals of facial reconstructive surgery:

1. Restore proper functions (like vision, chewing, swallowing or breathing through your nose).
2. Enhance and optimize your appearance.

How long does it take to recover after a facial fracture?

It’s different for everyone. It depends on several factors, including the extent of your facial trauma, which treatment you had and your body’s own healing capacity.

People who go through facial reconstructive surgery usually notice that swelling and bruising fade after about two weeks. But it can take up to a few months for complete recovery.

How can I lower my risk for facial fractures?

There’s no way to completely prevent facial fractures. However, you can take some steps to reduce the extent of injuries.

• Wear a seat belt when driving a motor vehicle or riding in one. Wear a helmet and other protective gear if you’re operating a motorcycle or all-terrain vehicle.
• Wear the correct protective equipment — such as a helmet, face mask or mouth guard — when playing sports.
• Follow safety guidelines at work and wear protective headgear if your job requires it.

What are the long-term effects of a facial fracture?

Some people may not have long-term effects following a facial fracture. However, long-term complications are possible and may include:

• Sinus issues.
• Breathing issues.
• A change in your sense of taste or smell.
• Tingling or numbness.
• Vision issues.
• Headaches.
• Tenderness in your head or face.

Early intervention and treatment can reduce your risk for long-term complications. Your healthcare provider can tell you what to expect in your situation.

When should I see my healthcare provider?

If you think you could have a facial fracture, it’s important to seek medical help right away. Call a healthcare provider if you develop:

• Pain or tenderness at the injury site.
• Swelling.
• Redness.
• Bruising.
• Deformity.
• Loss of function.

When should I go to the ER?

Head to your nearest emergency room if you have any of the following:

• Open wounds where you can see the bone.
• Bloody or clear discharge from your nose.
• Blurred or double vision, or problems moving your eyes.
• Trouble swallowing or breathing.
• Displaced jaw or nose.
• Upper and lower jaw that don’t meet properly, or pain when you move your jaw.
• Loose teeth.
• Pain and swelling in your face.

What questions should I ask my healthcare provider?

If you have facial trauma or fractures, here are some questions you might want to ask your healthcare provider:

• How many fractures are there?
• What are my treatment options?
• Will I need surgery now or in the future?
• How long will recovery take?
• When can I go back to work or school?
• How can I protect this area during healing?

How serious is a facial fracture?

The majority of facial fractures aren’t life-threatening. However, some can lead to serious issues with your vision, airways, respiratory system or central nervous system.

You should see a healthcare provider any time you have facial trauma, even if you think it’s not serious. They can recommend appropriate treatment.

Can a facial fracture heal on its own?

It’s possible for a facial fracture to heal on its own, especially if the broken bone stays in its proper position. However, in many cases, a healthcare provider will need to reset your facial bones for proper healing.

A note from Cleveland Clinic

Facial fractures are a result of trauma. Sometimes the damage extends beyond what you can see. Chances are, it’s not serious and only requires nonsurgical treatment. But if you have a severe facial fracture, or several complex fractures, you’ll probably need surgical intervention. If you think you have a broken facial bone, it’s important to seek medical care right away. Prompt treatment can reduce your risk of long-term complications.