Facial fractures

Changed by Henry Knipe, 22 Sep 2014

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Facial fractures are commonly caused by blunt or penetrating trauma sustained during motor vehicle accidents, assaults, and falls.

PathophysiologyEpidemiology

Males are affected more commonly than females and facial fractures are most common in the third decade ⁴.

Pathology

The ~~facial~~"facial buttress" concept elucidates the structurally meaningful skeletal struts that play a role in facial form and function and helps identify the regions that are likely to require surgical reconstruction.

Radiographic features

~~Plain X rays~~

Nasal bones are ~~relatively insensitive~~~~to facial fractures.~~

~~Multidetector computed tomography (CT)~~ is the ~~modality~~most commonly fractured single bone, followed by the mandible and the bony orbit. Fractures involving more than one bone most ~~often used for imaging evaluation in facial fractures because;~~commonly affect the orbital floor and zygomaticomaxilla ⁴.

Types

~~it's a rapid exam with easier patient positioning~~

~~it provides high image resolution which allows accurate detection of subtle facial fractures and also clearly delineates soft-tissue features~~

Types

Complexcomplex fractures which involve multiple facial buttresses

Fractures

fractures which involve a single facial ~~buttres~~buttress:

frontal sinus fracture
nasal bone fracture
orbital blow-out fracture
isolated zygomatic arch fractures
paranasal sinus fractures
alveolar process fractures
mandibular fracture

Radiographic features

Plain film

Plain x-rays are relatively insensitiveto facial fractures.

CT

MDCT is the modality most often used for imaging evaluation in facial fractures because of:

rapid examination with easier patient positioning
providing high image resolution which allows accurate detection of subtle facial fractures and also clearly delineates soft-tissue features

-<p><strong>Facial fractures</strong> are commonly caused by blunt or penetrating trauma sustained during motor vehicle accidents, assaults, and falls.</p><h4>Pathophysiology</h4><p>The facial buttress concept elucidates the structurally meaningful skeletal struts that play a role in facial form and function and helps identify the regions that are likely to require surgical reconstruction.</p><h4>Radiographic features</h4><p><strong>Plain X rays</strong><strong> </strong>are relatively insensitive<strong> </strong>to facial fractures. </p><p><strong>Multidetector computed tomography (CT)</strong> is the modality most often used for imaging evaluation in facial fractures because;</p><ul>
~~-<li> it's a rapid exam with easier patient positioning </li>~~
~~-<li> it provides high image resolution which allows accurate detection of subtle facial fractures and also clearly delineates soft-tissue features</li>~~
~~-</ul><h4>Types</h4><h5>Complex fractures which involve multiple facial buttresses</h5><ul>~~
~~-<li><a href="/articles/naso-orbitoethmoid-noe-complex-fracture">Naso-orbitoethmoid (NOE) complex fracture</a></li>~~
+<p><strong>Facial fractures</strong> are commonly caused by blunt or penetrating trauma sustained during motor vehicle accidents, assaults, and falls.</p><h4>Epidemiology</h4><p>Males are affected more commonly than females and facial fractures are most common in the third decade <sup>4</sup>. </p><h4>Pathology</h4><p>The "facial buttress" concept elucidates the structurally meaningful skeletal struts that play a role in facial form and function and helps identify the regions that are likely to require surgical reconstruction.</p><p>Nasal bones are the most commonly fractured single bone, followed by the mandible and the bony orbit. Fractures involving more than one bone most commonly affect the orbital floor and zygomaticomaxilla <sup>4</sup>. </p><h5>Types</h5><ul>
+<li>
+<strong>complex fractures which involve multiple facial buttresses:</strong><ul>
+<li><a href="/articles/naso-orbitoethmoid-noe-complex-fracture">naso-orbitoethmoid (NOE) complex fracture</a></li>
~~-<li><a href="/articles/le-fort-fractures">Zygomaticomaxillary complex fracture</a></li>~~
~~-</ul><h5>Fractures which involve a single facial buttres</h5><ul>~~
+<li><a href="/articles/le-fort-fractures">zygomaticomaxillary complex fracture</a></li>
+</ul>
+</li>
+<li>
+<strong>fractures which involve a single facial buttress:</strong><ul>
+</ul>
+</li>
+</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>Plain x-rays are relatively insensitive<strong> </strong>to facial fractures. </p><h5>CT</h5><p>MDCT is the modality most often used for imaging evaluation in facial fractures because of:</p><ul>
+<li>rapid examination with easier patient positioning </li>
+<li>providing high image resolution which allows accurate detection of subtle facial fractures and also clearly delineates soft-tissue features</li>

References changed:

4. Hwang K, You SH. Analysis of facial bone fractures: An 11-year study of 2,094 patients. Indian J Plast Surg. 2010;43 (1): 42-8. <a href="http://dx.doi.org/10.4103/0970-0358.63959">doi:10.4103/0970-0358.63959</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938622">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20924449">Pubmed citation</a><span class="auto"></span>

Images Changes:

Image ( update )

Caption was changed:

Case 3: Le Fort fracture (type II)

Image 1 CT (3D reconstruction) ( update )

Caption was added:

Case 1: naso-orbitoethmoid (NOE) complex fracture

Image 2 CT (3D VR) ( update )

Caption was added:

Case 2: zygomaticomaxillary complex fracture

Image 4 CT (bone window) ( create )

Image 5 CT (bone window) ( create )

Image 6 X-ray ( create )

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