Doctors divide the human skull into two parts: the hard bony dome that covers the brain, called the neurocranium, and the bones of the face and jaw, called the viscerocranium. While a fracture to the viscerocranium is technically a fracture to a part of the skull, it is often colloquially called a “facial” fracture.
The bones of the face can be delicate compared to the tough, fused bones that make up the dome of the skull. Facial fractures may happen when the front of the head slams into a hard object like a car’s steering wheel, dashboard, window, or the back of a car seat. Facial fractures can also happen when someone falls face-first onto a hard surface like pavement, asphalt, concrete, or even a wooden floor. The bones that make up the viscerocranium can also be damaged when a hard object is dropped on them or swung into them. Athletes in certain sports may be at particular risk for facial fractures if they run into opponents, fall, or get hit in the face by sporting equipment. Bullets and sharp implements can also penetrate or fracture the bones of the face.
What are the different types of facial fracture?
In a closed fracture, the bone is cracked or separated, but there is no break or cut in the skin covering the fracture. There may, however, be significant bruising or swelling in this area, and there could still be damage to soft tissues like the muscles and blood vessels underneath the skin.
In an open or compound fracture, the broken bone emerges through the skin.
Because there are so many different parts of the face, symptoms and treatment will be highly dependent on the exact location of the fracture.
A broken nose or nasal fracture involves an injury to the hard bony bridge of the nose, above the cartilage. These are the most common types of facial fracture.
A broken jaw or mandible fracture involves damage to the jawbone, also called the mandible. In addition to fracturing, the jawbone can also dislocate, causing pain and potentially long-lasting problems at the temporomandibular joint. After the nose, the jaw is the most commonly fractured bone in the face.
A fracture to the middle of the face is a maxillary fracture. These fractures usually happen during high-speed car accidents; their treatment is often complicated by the fact that an accident that causes them may have also caused extensive areas to other parts of the body.
A fracture of the cheekbone, the ridge that protrudes from the face below and to the side of the eye sockets, is called a zygomatic fracture. Patients with these fractures may notice problems with their vision or changes to the shape of their cheek.
A fracture of the eye socket, the bones that surround and protect the delicate fluid-filled eyeball, is an orbital fracture. These bones can also cause changes in the function and appearance of the ey.
How can facial fractures be treated?
Unlike the long bones of the arms, legs, and fingers, a fractured bone in the face can’t be put into a cast to stabilize it while it heals. This doesn’t mean that there’s no treatment available for facial fractures.
For severe fractures, a doctor may need to make sure that the broken bone is aligned so that it can heal correctly. This may involve a surgical procedure in which the bones are realigned. Surgery may be done if the fracture could potentially damage a delicate body part like the eyeball, if there is a significant cosmetic concern, or if the fracture may affect a vital function like breathing.
In many cases, no surgery is necessary to fix a facial fracture. In these situations, a doctor will focus on managing the patient’s pain, reducing swelling, and protecting the injured area as it heals.
The prognosis after a facial fracture is usually good. These fractures aren’t usually life-threatening, although patients may need follow-up care to fix cosmetic issues and prevent potential problems like loss of sight or problems with breathing.