Facial trauma

Facial trauma is any injury of the face and upper jaw bone.

Alternative Names

Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries

Causes, incidence, and risk factors

Blunt or penetrating trauma can cause injury to the midface region, which includes the upper jaw (maxilla). Common causes of facial injury include:

  • Automobile accidents
  • Violence
  • Penetrating injuries

    • Signs and tests

    On physical exam:

  • Lacerations (breaks in the skin) are often seen.
  • Bruising around the eyes and/or widening of the distance between the eyes may indicate injury to the bones between the eye sockets.
  • When the upper jaw moves with the head stabilized, there may be a fracture in this area.
  • Abnormal sensations on the cheek and irregularities that can be felt on the facial region can indicate fractures.
  • The physical exam is often complimented by a
    • CT scan of the head .

    Treatment

    When the patient is unable to perform any normal function, or a substantial cosmetic deformity occurs, the treatment is usually surgical. Goals include:

  • Establish a clear airway.
  • Control bleeding.
  • Treat the fracture.
  • Rule out other injuries.
  • Fix broken bone segments with titanium plates and screws.
  • Use existing lacerations and incisions in the mouth and around the eye and scalp during surgery to minimize scarring.
  • Treatment should be immediate, as long as the patient is stable and cleared of all life-threatening injuries and the neck has been cleared of fractures.

    • Expectations (prognosis)

    Patients generally do very well with proper pre-operative workup and planning. The patient should be fore-warned that they will most likely look different from their pre- injury state and that revision surgeries may be necessary 6 to 12 months later.

    Complications

    General complications include, but are not limited to:

  • Bleeding
  • Infection
  • Neurologic complications
  • Facial asymmetry

    • Calling your health care provider

    Go to the emergency room or call the local emergency number (such as 911) if you have a severe injury to your face.

    Prevention

    Wear seat belts and use protective head gear when appropriate. Avoid triggering potentially violent confrontations with other people.

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