Munson Health
 
Skull and Facial Fracture

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by Kellicker PG

(Head Injury; Open Skull Fracture; Closed Skull Fracture; Fracture, Skull and Facial; Maxillary Fracture; Le Fort Fracture; Mandible Fracture; Zygomatic Fracture)

 

Treatment

If you are in a situation where there is a skull or facial fracture injury, call for medical help right away.
Treatment will depend on the location and extent of the injury.

Stabilizing the Injury

The first steps will be focused on stabilizing your injury. They may include:
  • Attaching a backboard to stabilize the head and neck
  • A breathing tube for a blocked airway
  • IV fluids
  • Admission to the hospital for monitoring
Stabilization may also require emergency surgery to protect surrounding tissues and organs.

Initial Care

Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:
  • Without surgery—you will have anesthesia to decrease pain while the doctor moves the pieces back into place
  • With surgery—plates or wires may be needed to reconnect the pieces and hold them in place
Nearly half of skull and facial fractures require surgical repair. Surgery may not be done until the fracture is stabilized and swelling at the injury site goes down.

Hospitalization

People with these fractures usually need to stay in the hospital. Serious injuries may need to be watched in an intensive care unit. Some people with skull or facial fractures need to have help breathing. A tube is inserted and mechanical ventilation is used to protect and assist breathing.

Medications

You may need the following:
  • Pain medication
  • Antiseizure medications
  • Medications to reduce pressure inside your head or brain swelling
  • Antibiotics if an infection is present or possible

Rest and Recovery

Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it may take several weeks for a skull or facial fracture to heal.
You will need to adjust your activities while you recover, but complete rest is rarely required. Ice may also be recommended to help with discomfort and swelling.
As you recover, you may be referred to physical therapy or rehabilitation to keep your muscles strong. Do not return to activities or sports until your doctor gives you permission to do so.
 

RESOURCES

American College of Emergency Physicians.
http://www.acep.org

Brain Injury Association of America
http://www.biausa.org

 

CANADIAN RESOURCES

Canadian Association of Emergency Physicians
http://www.caep.ca

The Brain Injury Association of Canada
http://biac-aclc.ca

 

References


Facial fractures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/head%5Fneck/patients/facial%5Fplastic%5Freconstructive%5Fsurgery/facial-fractures.aspx. Accessed September 16, 2013.


Maxillofacial injuries. Patient UK website. Available at: http://www.patient.co.uk/doctor/Maxillofacial-Injuries.htm. Updated December 20, 2010. Accessed September 16, 2013.


Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated August 23, 2013. Accessed September 16, 2013.


NINDS traumatic brain injury information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tbi/tbi.htm. Updated February 11, 2013. Accessed September 16, 2013.


Park CH, Lee JH, et al. Reduction of inferior orbital wall fractures using a Foley catheter and an endoloop. J Trauma. 2011;70(3):E38-E41.


Subdural hematoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated October 22, 2012. Accessed September 16, 2013.


Traumatic brain injury. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated August 15, 2013. Accessed September 16, 2013.

 

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