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FACIAL BONES, FRACTURE OF

DESCRIPTION

Fracture of facial bones means, simply, broken bones in the face. The facial nerves, blood vessels, skin, and bones are involved. The facial bones include those of the upper jaw (maxilla), of the lower jaw (mandible), of the cheek (zygoma), and around the eyes (orbital), as well as the nose (see Nose Fracture in Illnesses section).
Appropriate health care includes:
  • Physician's monitoring of general condition, medications, and treatment. A plastic surgeon, oral surgeon, ophthalmologist, or ear, nose and throat specialist may be consulted.
  • Surgery to realign fractured bones and reconstruct normal facial contours.
  • Self-care after diagnosis and treatment.

    SIGNS & SYMPTOMS
    The following apply to the site of your child's injury:

  • Swelling.
  • Tenderness, crepitation (a crackly feeling upon touching), or pain.
  • Redness that becomes multicolored soon after injury.
  • Loss of sensation in the lips and nose from nerve damage.
  • Double or blurred vision.

    CAUSES
    Injury, especially from auto or bicycle accidents, sports injuries, and fist fights.

    RISK FACTORS

  • Hostile, aggressive personalities.
  • Participation in contact sports.
  • Excess alcohol consumption.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Instructions for your child:
    Avoid injury whenever possible. Wear protective headgear for contact sports or when riding motorcycles or bicycles. Use auto seat belts. Don't drink or use mind-altering drugs and drive.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies to measure blood loss.
  • X-rays of the child's skull and facial bones.
  • Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).

    POSSIBLE COMPLICATIONS

  • Infection in the injured area.
  • Permanent disfigurement.

    PROBABLE OUTCOME

  • Surgery usually produces good cosmetic results and a return to normal function. It should be done as soon as possible after your child has been injured.
  • Teeth that have been knocked out can sometimes be replanted. A broken jaw is corrected by securing the teeth with wire or plastic splints so the jaw heals in its proper position. Your child's speech will be changed while the wires are in place, but it should return to normal when they are removed. Normal vision should return if the child's eye is not injured.
  • Allow about 6 weeks for recovery.

    TREATMENT

    HOME CARE

    Instructions for your child:
  • Don't exercise to the point that you must pant for breath, because breathing may be difficult for a while.
  • Protect your face from pressure. Sleep on your back.
  • Don't blow your nose hard or use makeup until healing is complete.
  • If your jaws are wired, learn how to release them quickly in case of emergency, such as severe coughing or vomiting.

    MEDICATION
    Your doctor may prescribe:

  • Pain relievers.
  • Antibiotics to fight infection, if necessary.

    ACTIVITY
    Your child should rest quietly for about 2 days, then resume normal activities as strength returns.

    DIET & FLUIDS
    Your child should eat a high-protein, liquid diet for several days. If the child's jaw is wired, the liquid diet will be necessary for up to 8 weeks. Add soft solid foods when the child is able to eat them. Give the child vitamin and mineral supplements to hasten healing.

    OK TO GO TO SCHOOL?

    Yes, when general health and state of well-being permit.

    CALL YOUR DOCTOR IF

  • Your child has a facial-bone fracture.
  • The following occurs during treatment: fever; impaired vision; severe headache; loss of sensation in the child's face; intolerable pain; illness of any kind during healing; loosening of wires or splints.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects. ‡
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