Facial Fracture Treatment in Pune: Facial Trauma and Bone Repair

What is facial trauma?

Facial trauma covers injuries to the soft tissues and bones of the face from road accidents, falls, assaults, sport and work injuries. The face contains the airway, the eyes, the teeth and jaws, and nerves for feeling and expression, so even a small fracture can affect breathing, vision, eating or appearance.

Common fractures include:

• Nose (nasal bones): the most common facial fracture.
• Cheekbone (zygoma): flattening of the cheek, numbness of the cheek and upper lip, difficulty opening the mouth.
• Eye socket (orbit): double vision, a sunken eye or limited eye movement.
• Lower jaw (mandible): pain, a changed bite, numbness of the lower lip.
• Upper jaw (maxilla, Le Fort fractures): a mobile upper jaw and a changed bite.

How are facial fractures assessed?

1. Emergency assessment of the airway, bleeding and head and neck injuries, which take priority.
2. Examination of the face, eyes, nose, bite and teeth, and feeling and movement of the face.
3. CT scan of the facial bones, the standard test for all but simple nose fractures.
4. Eye and dental assessment when the eye socket or teeth are involved.
5. Tetanus status and care of any cuts; see cosmetic stitches for face cuts.

What are the treatment options?

Treatment	Suits	Points to consider
Observation and soft diet	Fractures that are not displaced and do not affect function	Regular review
Closed reduction of the nose	Displaced nasal fractures, within about 2-3 weeks	Often under local anaesthesia; no cuts
Open reduction and plating	Displaced cheekbone, eye socket and jaw fractures	General anaesthesia; small titanium plates
Temporary jaw wiring or elastics	Some jaw fractures	Liquid or soft diet for a period
Eye socket repair	Fractures causing double vision or a sunken eye	Plate or implant to rebuild the socket floor
Later reconstruction	Old, healed fractures with deformity	Bone may need to be re-cut and repositioned

A nose that has healed crooked can later be corrected with rhinoplasty. Facial nerve injuries are covered under nerve repair surgery.

How is facial fracture surgery performed?

1. Anaesthesia: usually general anaesthesia.
2. Access: through cuts inside the mouth, inside the lower eyelid, in the eyebrow, or through existing wounds, to limit visible scars.
3. Reduction: the broken bones are moved back into their correct position, with the bite checked for jaw fractures.
4. Fixation: small titanium plates and screws hold the bones while they heal.
5. Closure: fine dissolvable stitches; swelling is controlled with head elevation and cold packs.

How should you prepare, and what should you ask?

• Avoid blowing your nose if a cheekbone or eye socket fracture is suspected.
• Keep to a soft diet if your jaw hurts or your bite feels different.
• Keep your head raised to reduce swelling.

Questions to ask:

• Which bones are broken, and do they need surgery?
• Where will the cuts be?
• Will my bite, vision or feeling be affected?
• When can I return to work and sport?

What is recovery like?

Time	What to expect for most patients
Days 1-3	Swelling and bruising peak; head raised; cold packs
Weeks 1-2	Swelling settles; many return to desk work
Weeks 1-6	Soft diet for jaw fractures; avoid nose blowing for eye socket fractures
About 6 weeks	Bones knit; return to normal diet
6-8 weeks or more	Return to contact sports when advised

What are the risks?

• Infection of the wound or plates.
• Bite problems after jaw fractures.
• Numbness of the cheek, lip or chin, often improving over months.
• Double vision or a sunken eye after eye socket fractures.
• Asymmetry, needing further surgery.
• Breathing problems or deformity after nasal fractures.

Contact the team for fever, increasing swelling, pus, a change in vision or a sudden change in your bite.

What results can you expect?

Most facial fractures heal well with appropriate treatment, restoring the bite, vision and facial shape. Some people have lasting numbness or minor asymmetry, which can often be improved later if needed.

What happens if a facial fracture is not treated?

Fractures that are not displaced and do not affect the bite, vision or breathing often heal well with a soft diet and review. Displaced fractures are different, because facial bones start to set within a few weeks. A broken nose can heal bent, with a blocked nostril. A cheekbone can heal flat, leaving a hollow and sometimes difficulty opening the mouth. An eye socket fracture can leave a sunken eye and lasting double vision. A jaw fracture can heal so the teeth no longer meet, making chewing difficult.

Once bones have healed in the wrong place, correction usually means re-cutting and repositioning them, a larger operation than early repair. Early review is therefore worthwhile even when the injury seems minor.

Common myths about facial fractures

• “A broken nose will straighten by itself once the swelling goes down.” Swelling can hide a bend, so the nose is rechecked after a few days, and straightening is simplest within about two to three weeks.
• “If I can open my mouth, my jaw cannot be broken.” A jaw can be fractured and still move; a bite that feels different or numbness of the lower lip needs checking.
• “A bone-setter can press the bones back into place.” Facial fractures near the eye, sinuses and teeth need a scan and precise fixation.
• “Face fracture surgery always leaves large scars.” Most fractures are reached through cuts inside the mouth, inside the eyelid or in natural creases.

What affects the cost of facial fracture treatment in Pune?

• Number and type of fractures.
• Treatment: observation, nasal manipulation or open surgery with plates.
• CT scans, anaesthesia and hospital stay.
• Plates and implants used.

Treatment after an accident or injury is usually medical care and is often covered by health or accident insurance.