Facial Fractures

Overview

Facial fractures are breaks in the bones that make up the structure of the face, including the nose, cheekbones, eye sockets (orbits), upper jaw, and lower jaw (mandible). They usually result from a direct blow or impact, such as a fall, sports injury, assault, or vehicle crash.

Because the face contains the airway, eyes, and many nerves and blood vessels, facial fractures range from minor (such as a simple broken nose) to serious injuries that affect breathing, vision, or the brain. Some facial fractures are medical emergencies. Prompt evaluation helps protect these vital structures and supports good healing and appearance.

Symptoms

Symptoms depend on which bones are broken but commonly include:

• Pain, swelling, and bruising of the face
• Visible deformity, flattening, or a change in face shape
• Nosebleed or bleeding from the mouth
• Numbness in parts of the face
• Difficulty opening the mouth or a change in how the teeth fit together
• Double vision, blurred vision, or trouble moving the eye
• Black eyes or swelling around the eyes

Warning signs needing emergency care include difficulty breathing, heavy bleeding, vision loss, clear fluid draining from the nose, or loss of consciousness.

Causes

Facial fractures are caused by force applied to the face:

• Falls: A common cause, especially in older adults and young children.
• Assaults and fights: Direct blows to the nose, cheek, or jaw.
• Sports injuries: Contact sports and activities without face protection.
• Motor vehicle and bicycle crashes: High-impact trauma to the face.

Risk Factors

• Participation in contact or high-speed sports
• Not wearing seatbelts, helmets, or face guards
• Activities or environments with high fall risk
• Osteoporosis or other conditions that weaken bone
• Situations involving violence

Diagnosis

Diagnosis combines examination with imaging:

• Physical exam: Checking for deformity, tenderness, numbness, eye movement, vision, and how the teeth meet.
• CT scan: The main imaging test for facial bones, showing the location and extent of fractures.
• X-rays: Sometimes used for simpler injuries such as a broken nose or jaw.

Treatment

Treatment depends on which bones are broken and how badly they are displaced.

• Conservative care: Many minor fractures, including some broken noses, heal with rest, ice, pain relief, and time.
• Realignment: A displaced nose or other bone may be gently put back into position.
• Surgery: More serious or displaced fractures may need surgery with plates, screws, or wires to hold the bones in place while they heal.
• Protecting function: Care also focuses on the airway, eyes, and bite, and may involve specialists such as oral, eye, or facial surgeons.

Antibiotics may be given for fractures that involve the sinuses or open wounds.

Prevention

• Wear seatbelts and use proper child restraints in vehicles
• Use helmets and face guards in sports and on bicycles
• Reduce fall hazards at home, especially for older adults
• Use safety equipment at work when there is a risk of facial injury

When to Seek Care

Have any suspected facial fracture evaluated promptly, as some injuries are not obvious and can affect vision or the bite. Seek emergency care immediately if there is difficulty breathing, heavy bleeding that will not stop, loss of vision or double vision, clear fluid draining from the nose or ears, severe swelling, or loss of consciousness after the injury. These can signal serious damage to the airway, eyes, or brain.

Related Topics

Frequently Asked Questions

References

1. American Academy of Otolaryngology–Head and Neck Surgery. Facial Trauma.
2. Mayo Clinic. Broken nose.
3. MedlinePlus, U.S. National Library of Medicine. Facial trauma.
4. American Association of Oral and Maxillofacial Surgeons. Facial Injury and Trauma Surgery.