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Facial Fractures Care and Repair: Orbital, Nasal, Maxilla or Mandible (Jaw) and Other Facial Fractures (6773)

Facial Fractures Care and Repair: Orbital, Nasal, Maxilla or Mandible (Jaw) and Other Facial Fractures (6773) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Trauma

6773




Facial Fracture Care and Repair
Orbital, Nasal, Maxilla or Mandible (Jaw) & Other Facial Fractures


Orbital Fractures

What is an orbital fracture?
When one or more bones are broken in the
eye socket it is called an orbital fracture.
Sometimes it is called a blow-out fracture
when the fracture occurs in the floor (lower
part) of the orbit. It may involve the orbit
and the cheek bone, called the zygoma or
extend from the orbit into the nasal and
ethmoid bones (found inside the nose under
the orbit). These fractures can occur from
falls, motor vehicle crashes, sports
accidents, assaults and other forms of
trauma to the face or head.

www.rad.washington.edu
Used with permission.









What are the symptoms?
Symptoms include bruising or swelling
around the eye, changes in feeling, a
“sunken eye” appearance, changes in vision
such as double vision, and decreased
movement of the injured eye.

How is it diagnosed?
They are found on physical exam or by x-
rays or CT scans.




How are these fractures treated?
Treatment depends on where the fracture
is and how severe it is.

ξ In many cases no surgery is
needed.
ξ Cold wet packs may be used for the
first 36 to 48 hours after trauma or
surgery to reduce swelling.
ξ The head of your bed will be raised
to decrease bleeding and swelling.

Orbital fractures may need to be repaired
in surgery. The surgeon may wait until
swelling and bruising decrease before
operating.



Broken Nose or Nasal Fracture

What are nasal fractures?

A nasal fracture or broken nose is the
most common type of facial fracture. It
occurs when there is a crack or break in
one of the two bones over the bridge of
the nose. A more severe fracture may
extend into the orbit of the eye or
through the ethmoid bone beneath the
orbit. These fractures can occur from
falls, sports accidents, assaults, motor
vehicle crashes and other forms of
trauma to the face or head.



What are the symptoms of nasal
fractures?
Symptoms include pain, bruising, swelling
or misshapen nose. The nose may have
blood or clear spinal fluid drainage from it.
Other symptoms are bruising and swelling
of the eyes and trouble breathing through the
nose.

How is a nasal fracture diagnosed?
A broken nose is found by physical exam or
with an x-ray.

How are nasal fractures treated?
Treatment depends on where the fracture is
and how severe it is.

ξ In many cases no surgery is
needed.
ξ Ice or cold packs will be applied to
the injured area of your nose (15 - 20
minutes each hour while awake to
reduce swelling). Ice will be applied
at least 3-4 times a day for 2 days.
The ice will be placed in a small
plastic bag, with a towel between the
ice and your skin.
ξ The head of the bed will be raised to
decrease bleeding and swelling.
ξ Sometimes the doctor will place soft
gauze in the nose (nasal packing) to
stop nose bleeding.
ξ If the nose is not in line, the doctor
may straighten it by hand.

If plastic surgery is needed to repair the
fractures, the surgeon may wait until
swelling and bruising decrease before
operating.

Jaw Fractures

What is a fractured jaw?
A fractured jaw occurs when one or more
bones are broken in the upper jaw (maxilla)
or lower jaw (mandible). Le Fort I, II, or
III are names for fractures that involve the
jaw. These fractures can occur from falls,
motor vehicle crashes, sports accidents,
assaults, and other forms of trauma to the
face or head.

What are the symptoms of jaw fractures?
Symptoms include bruising, swelling, pain,
and tenderness over the fracture site. There
may be numbness, cuts, bleeding, facial
deformity, malocclusion (the feeling that your
teeth don’t bite together like they should),
misalignment of teeth, and lost or loosened
teeth.

How are jaw fractures diagnosed?
A broken jaw is found by physical exam or
with an x-ray. Sometimes the fracture is
seen on a CT scan of the head, which was
done for other purposes.

How are jaw fractures treated?
Treatment depends on where the fracture is
and how severe it is.

 In some cases the jaws are
immobilized for 1-8 weeks through
maxillo-mandibular fixation
(MMF) where the jaws are lined up
and arch bars (like braces) are put in
place and wired or rubber banded to
keep your jaws shut. This allows
the break to heal in a correct
manner.



 Open reduction and internal
fixation (ORIF) surgery may be

needed for certain types of fractures
and more severe fractures.
 Ice or cold packs will be applied to
the injured area of your jaw (15 - 20
minutes each hour while awake to
reduce swelling). Ice or cold packs
will be applied at least 3-4 times a
day for 2 days after injury or
surgery. The ice will be placed in a
small plastic bag, with a towel
between the ice and your skin.
 The head of the bed will be raised to
decrease bleeding and swelling.
 If you need surgery, the surgeon
may wait until swelling and bruising
decrease before operating.

How are my teeth & mouth cleaned?
 A children’s toothbrush, rinsed in
warm water to soften will be used
with toothpaste to brush your teeth
each morning, before bed, and after
meals. The children’s toothbrush
works better than a soft toothbrush
to remove bacteria, blood, mucus
and other matter that can cause
infection or tooth decay. Toothettes
(mouth cleaning sponges) do not
clean the bacteria and debris from
teeth to prevent infection or decay
after MMF or surgery of the mouth.
 Your mouth will be rinsed with
saline (salt water) or a prescribed
mouth wash after injury, MMF, or
ORIF.

How will I be fed?
 Once you are cleared to drink, you
will be given clear liquids. Next
your diet will be advanced to full
liquids, then to the a Pureed Diet
which is blenderized foods that need
to be thinned with a little water or
milk so that you are able to drink the
food. The nutritionist will explain
this diet to you and give you
information on how to make food
for yourself that will be safe for you
to eat.

Cheekbone (Zygomatic) Facial
Fractures

What is a cheekbone (zygomatic)
fracture?

A zygomatic fracture is a fracture of the
cheekbone caused by a direct blow to the
cheek. These fractures can occur from
sports accidents, assaults, falls, motor
vehicle crashes, and other forms of trauma
to the cheekbone.

What are the symptoms?
Symptoms include bruising, swelling, pain
and tenderness over the fracture site. There
may be numbness, cuts, bleeding, and facial
deformity. There may also be symptoms of
orbital fracture(s).

How are they diagnosed?
A broken cheekbone is found by physical
exam or with an x-ray.

How are they treated?
Treatment depends on the where the fracture
is and how severe it is.

In some cases no operation is needed.
ξ Ice will be applied to the injured area
of your nose (15 - 20 minutes each
hour while awake to reduce
swelling).
ξ Ice or cold packs will be applied at
least 3-4 times a day for 2 days. The
ice will be placed in a small plastic
bag, with a towel between the ice
and your skin.
ξ The head of the bed will be raised to
decrease swelling.
Other fractures may need surgery to repair.
The surgeon may wait until swelling and
bruising decrease before operating.


When do I need to call my nurse or
doctor?

Call your nurse or doctor if you have

 Trouble breathing or start to choke.
 Increased pain at the injury or
surgical site.
 A change in vision.
 Numbness or tingling at the injury
or surgical site.

What do I need to know before going
home?

Special Health Facts for You (HFFY) will
be reviewed with you to explain your
discharge.



Who do I call for questions?


 Call Dr. _________________ office @ 608-____________ 8:00-4:30 weekdays

 After hours, on weekends, and holidays call UW Hospital Paging Operator at 608-
262-0486. Ask for the ENT doctor on call. Give your name and phone number with
area code to the operator. A health care provider will call you back.

 If you live out of the area call: Toll free 1-800-323-8942



















Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©10/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6773.