Facial Bone Fractures: Diagnosis, Repair Methods, and the Surgical Process
Because the facial region is exposed to trauma, it is an area where bone fractures are frequently encountered. In particular, fractures of the cheekbone (zygomatic bone), nasal bone, lower jaw (mandible), and upper jaw (maxilla) may occur due to causes such as traffic accidents, sports injuries, or falls.
The main goal of treatment is to repair the facial bones in the correct anatomical position and to avoid leaving a permanent scar or deformity on the face in both functional and aesthetic terms. In addition, when facial bone fractures are detected, the patient must also be thoroughly evaluated for intracranial, neck, thoracic, and abdominal trauma. Ruling out life-threatening conditions is the priority in this process.
Periorbital (Orbital) Fractures
When the bones around the eye fracture, symptoms such as double vision (diplopia), restricted eye movements, and a sunken appearance of the eye socket (enophthalmos) may occur. This can affect both visual function and aesthetic appearance. Moreover, depending on the severity of the fracture, damage to the optic nerves or surrounding tissues may develop.
Diagnosis and Evaluation
In diagnosing facial bone fractures, conventional X-rays may provide information in some cases; however, computed tomography (CT) is generally preferred for detailed evaluation. This allows the type and location of the fracture and its relationship with surrounding tissues to be clearly identified.
Surgical Planning and Treatment Methods
A treatment plan is determined according to the location and severity of the fracture and the patient’s overall condition. In some cases, medical follow-up and rest may be sufficient; however, surgical intervention is required especially for displaced fractures that impair function or aesthetics.
In facial fracture surgery, approaches that leave no visible scar or only minimal scarring are prioritized. If the patient has an existing trauma-related laceration and it is in an appropriate position, it may be used for surgical access. Otherwise, the surgeon may operate through intraoral incisions, eyelid incisions, or within the scalp so that the intervention is not visible externally.
During surgery, fractured bones are stabilized with titanium plates and screws. These materials are biocompatible and generally do not need to be removed.
Functional and Aesthetic Outcomes
Facial bone fractures matter not only in terms of appearance but also in terms of function. In particular, fractures of the upper or lower jaw can disrupt dental alignment (occlusion). This can negatively affect chewing, speaking, and overall facial balance. Similarly, asymmetric fractures may lead to loss of facial symmetry. The aim of surgery is to restore both aesthetic integrity and proper jaw closure.
Recovery Process and Care
In the postoperative period, swelling and bruising in the face are normal. These complaints usually subside within a few weeks. After surgeries involving the area around the eye, temporary double vision or restricted eye movement may occur, but these typically improve over time.
Regarding nutrition, liquid foods are recommended in the first days, especially for patients with jaw fractures. As healing progresses, patients transition to soft foods. In addition, if bleeding or leakage occurs after surgery, nasal packing and medical support measures may be used.