Types of Facial Fractures and their Surgical Treatments

Maxillary Fractures

A maxillary fracture is a break in the bones that make up the upper jaw. The maxilla is the bone that makes up the middle part of the face. It includes the area around the eye socket (orbit), nose, and cheekbone.

Maxillary fractures generally result from a collision with an immovable object, a fall from a great height, or a motor vehicle accident. Maxillary fractures are classified according to the Le Fort fracture classification system.

• Le Fort I: Also called horizontal fractures, the Le Fort I fractures are characterized by fractures that run up and over the top lip, separating the teeth from the maxilla, as well as the lower portion of the nasal passages.

• Le Fort II: Also called pyramidal fractures, Le Fort II fractures involve a break in the bridge of the nose and separation of the upper jaw from the rest of the face.

• Le Fort III: Also called craniofacial disjunction fractures, Le Fort III fractures are the most severe type of maxillary fracture. They extend across the bridge of the nose, through the eye sockets, and to the side of the face.

Patients with maxillary fractures present with malocclusion (misalignment of teeth), double vision, bleeding from the nose or mouth, and difficulty in breathing.

Surgical treatment for Maxillary Fractures

The surgical treatment for maxillary fractures is done under general anesthesia. The surgery will be determined by the fracture’s position and severity.

• Intermaxillary fixation (IMF): This surgery is used to stabilize the bones of the maxilla. It is done by placing wires or screws through the teeth into the bone.

• Open reduction and internal fixation (ORIF): In this type, Dr. Arun will make an incision in the skin to access the bone. The bone is then manipulated into the correct position and held in place with screws, wires, or plates.

Mandible Fractures

The mandible is the lower jawbone, and a fracture of the mandible is a break in this bone. Mandible fractures can range from a small crack to a complete break in the bone and may occur in any areas of the mandible, such as the condyles (where the mandible meets the TMJs or temporomandibular joints), ramus (vertical part of the mandible), body (horizontal part of the mandible which supports the teeth), angle (where the ramus connects to the body), and symphysis (front of the mandible).

Mandible fractures are generally caused by trauma to the face, such as from a fall, car accident, assault, or sports injury. Symptoms of a mandible fracture include pain, swelling, malocclusion (misalignment of teeth), numbness, and loose teeth.

Surgical treatment for Mandible Fractures

The surgical treatment for mandible fractures is done under general anesthesia. Depending upon the location and severity of the fracture in the lower jaw, Dr. Arun may perform closed reduction (moving the bone into the correct position without making an incision in the skin) and internal fixation or open reduction and internal fixation (ORIF).

Frontal Bone Fractures

The frontal bone is the bone that makes up the forehead. Frontal bone fractures can occur as a result of head trauma, such as from a fall or car accident. Symptoms of a frontal bone fracture include pain, swelling, bruising, and deformity of the affected area.

Surgical treatment for Frontal Bone Fractures

Based on the location and severity of the fracture, Dr. Arun will decide whether to perform frontal sinus ablation/obliteration, closed reductions, cranialization, or open reduction with internal fixation (ORIF).

Orbital Fractures

The orbit is the bony cavity that houses the eye. An orbital fracture is a break in any of the bones that make up the orbit. Orbital fractures usually occur as a result of blunt force trauma to the eye area.

Orbital fractures can be divided into three categories:

• Orbital rim fracture: A fracture of the bony rim that surrounds the orbit. It takes a lot of force to break the rim. One of the major reasons for this sort of fracture is car accidents. If someone has an orbital rim fracture, there’s a good chance they’ve also suffered other facial injuries, as well as the optic nerve.

• Blowout fracture: A fracture to the floor or inner wall of the orbit (eye socket) or eye socket. A crack in the extremely thin bone that makes up these walls can squeeze muscles and other structures around the eye, preventing the eyeball from moving freely. This type of fracture is common in sports injuries or getting hit by a fist.

• Orbital floor fracture: A fracture of the orbital floor is a break in the bone that makes up the bottom of the eye socket. This type of fracture can also cause damage to the muscles and nerves surrounding the eye, preventing it from moving properly and feeling normal.

Surgical treatment for Orbital Fractures

The surgical treatment for orbital fractures will depend on the location and severity of the fracture but in general, the goal of the surgery is to

• Expose the fracture’s location.
• Remove any tissue that is trapped in the fractured socket.
• Re-establish socket support, which is generally accomplished with an implant.

Nasal Bone Fractures

A nasal bone fracture is a break in the bone that forms the bridge of the nose and is among the most common facial bone fractures. Nasal bone fractures occur as a result of car accidents, sports injuries, and assaults. Symptoms of a nasal bone fracture include pain, swelling, bruising, difficulty in breathing, and deformity of the nose.

Surgical treatment for Nasal Bone Fractures

The most typical form of nasal fracture repair is closed nasal reduction. This is usually done using a general anesthetic. The bones are pushed back into position and held in place with a splint. If the septum is fractured (the center of the nose divides left from right), it may also be reduced and splinted at the same.

Naso-Orbito-Ethmoid (NOE) Fractures

The NOE complex is a bony skeleton made up of a union of bones from the nose, orbits, maxilla, and cranium. NOE fractures occur as a result of trauma to the midface’s center and can occur in isolation or can accompany other facial fractures. These fractures are among the most challenging of all facial fractures to detect and treat. They need to be managed properly to prevent functional and aesthetic deformities later.

Surgical treatment for Naso-Orbito-Ethmoid (NOE) Fractures

Open reduction and internal fixation are the standard care for treating these fractures. This means that the surgeon will make an incision to access the fracture and then use plates and screws to hold the bone in place while it heals. The surgeon will also address any other associated injuries at the same time.

Zygomaticomaxillary Complex Fractures

Zygomaticomaxillary Complex (ZMC) facial fractures are injuries to the zygoma (cheekbone) and surrounding facial bones. ZMC fractures are commonly the result of blunt force trauma to the cheek, such as from a car crash or a fight. It may cause flatness of the cheek, altered sensation under the eye, pain, and severe bruising. If the problem is not diagnosed, it can lead to undesirable cosmetic and functional outcomes.

Surgical treatment for Zygomaticomaxillary Complex (ZMC) Fractures

Immediate treatment is crucial to regain natural facial contour and provide support for the eyes. Surgical fixation by means of closed reduction or open reduction with internal fixation (ORIF) is the usual method.

What is the cost of Facial Fracture Fixation in Hubli?

Dr. Arun Jeedi will calculate the cost of the facial fracture fixation during the OPD consultation after considering the unique circumstances of the patient, understanding the patient’s goals and objectives, and discussing both advantages and disadvantages of various surgical treatments.