Facial bone fractures are the breaking and displacement of one or more of the bones that make up the face. They are most often seen as a result of traffic accidents, assault and sports injuries. Nasal fractures, jaw fractures, eye socket (orbital) fractures and cheekbone fractures are the most common types. These fractures are important because they can affect not only appearance but also functions such as breathing, chewing and vision.
Symptoms and which functions are affected
| Fracture site | Possible effect |
|---|---|
| Nose | Permanent airway obstruction, difficulty breathing, deformity |
| Eye socket (orbit) | Restricted eye movements, double vision, loss of vision in advanced cases |
| Lower and upper jaw | Impaired biting and speech, change in dental bite |
| Cheekbone | Restricted jaw movement, flattening of the facial contour |
General symptoms: bleeding, swelling, pain, tenderness and loss of sensation at the fracture site. Clear fluid coming from the nose or ear requires urgent assessment.
How is the diagnosis made?
The diagnosis is made by combining examination findings with imaging. Computed tomography provides the most detailed information in assessing the facial bones; the location of the fracture, the number of fragments and the amount of displacement are determined with this scan. Fractures involving the area around the eye are assessed together with ophthalmology, and those involving the jaw and dental bite together with the relevant specialties.
Does every fracture require surgery?
No. Fractures that are not displaced and are stable can be treated without surgery, with appropriate bandaging and splinting. Surgery is required in the following cases:
- If the bone ends have shifted
- If flattening or asymmetry of the facial contours has occurred
- If chewing, dental bite, eye movements or breathing are affected
How is the operation performed?
The procedure is mostly performed under general anaesthesia. Fine incisions are made to reach the fracture site; these incisions are planned in places that will remain as hidden as possible — inside the mouth, at the edge of the eyebrow or in the lower eyelid. The fractured bones are fixed in their original anatomical position with titanium plates and screws. Plate-and-screw treatment may not be needed for every patient; the decision is made according to the type of fracture.
The titanium materials used can remain in place for life as long as they do not cause problems. If a problem develops, they can be removed with a second procedure.
The right timing for surgery
The appropriate period is usually the first 1-2 weeks after the injury: some of the swelling is allowed to subside, but the procedure should be carried out before the bone heals in the wrong position. In situations that threaten the eyes or breathing, intervention is carried out urgently. In delayed cases, repair becomes more complex and the predictability of the result decreases.
Recovery process
| Period | What to expect | Recommendations |
|---|---|---|
| First 2-3 weeks | Swelling and bruising decrease markedly | Soft diet, no blowing of the nose |
| 6 weeks | Bone healing is largely complete | Protection from impacts continues |
| Over months | If a nerve has been affected, numbness may continue | Follow-up check-ups |
| With the doctor's approval | Return to contact sports | An early return carries a risk of a new fracture |
For other repair procedures, see the reconstructive surgery page, and for conditions related to the shape of the nose and breathing, see the rhinoplasty page. You can contact the clinic for an assessment.
Frequently Asked Questions
What are the symptoms of a facial bone fracture?
After an impact, marked swelling and bruising of the face, pain, flattening or asymmetry of the facial contours, difficulty opening and closing the mouth, a change in how the teeth fit together, double vision, restricted eye movements and numbness of the face may be signs of a fracture. Clear fluid coming from the nose or ear requires urgent assessment. With these symptoms, you should go to a healthcare facility without delay.
How are facial fractures diagnosed?
The diagnosis of facial fractures begins with examination of the patient. Facial swelling, bruising, pain, deformity, difficulty opening the mouth, numbness or problems with vision are assessed. Computed tomography (CT) is usually used to determine the location and extent of the fracture in detail. Based on the findings, the facial bones affected by the fracture are identified and appropriate treatment is planned.
Does every facial fracture require surgery?
No. If the bone ends have not shifted and there is no impairment of the facial contours or function, follow-up and supportive treatment may be sufficient. If the fracture is displaced, has caused flattening of the facial shape, or affects chewing or eye movements, surgical repair is required. The decision is made according to the type of fracture and the person's findings.
When should facial fracture surgery be performed?
The appropriate period for surgery is usually the first 1-2 weeks after the injury; some of the swelling is allowed to subside, but the procedure should be carried out before the bone heals in the wrong position. In situations that threaten the eyes or breathing, intervention is carried out urgently. In delayed cases, repair can become more complex.
How does recovery progress?
Bone healing is usually largely complete within 6 weeks. During this period, a soft diet, not blowing the nose and protection from impacts are recommended. Swelling and bruising decrease markedly in the first 2-3 weeks. If a nerve has been affected, numbness can last for months. Return to contact sports depends on the doctor's approval.