Repair of Facial Fractures

REPAIR OF FACIAL FRACTURES

Fractures of the facial bones can occur after traffic accidents, falling from a bicycle or from a high place. Of course, it is appropriate to repair facial fractures after first solving the patient’s fatal problems such as cerebral hemorrhage. The most affected bones are mandible, maxilla and zygoma. When there is a fracture in these bones, it can affect the nerves and have effects such as facial numbness, inability to open the jaw joint or painful opening, difficulty in eye movements and double vision. Fractures that do not cause such consequences may not require surgery. Fractures are usually repaired with plate screws. These plaques are very thin and very small. It is soft to adapt to the facial bones. The aim is to keep that bone structure in its anatomical position, in its normal position, until the bone structure heals. No extra bandage or dressing is applied in these patients. Sometimes we may also have to lock the jaw together in case of jawbone fractures. In these patients, they have to be fed with liquid and it causes serious weight loss for 3 weeks. These fractures are usually seen in traffic accidents and the operation is performed within 3-4 days after the edema subsides. The operation that can be performed immediately, which we call primary operation, is the operation to be performed within the first 3 weeks. But the earlier it is done, the less bone healing structures, which we call call callus, are formed in the bones. Incorrectly formed fracture healing and callus tissue can be removed within these 3 weeks. The earlier the surgery, the less likely this undesirable situation will occur. In bones that will heal in a normal position, this callus tissue and fracture healing structures are not a problem. It even accelerates fracture healing. By 3 weeks after the accident, the bone has healed and may need to be re-fractured to reshape it, which is very difficult compared to primary repair. Even after a fall, when there is numbness in the face, impaired eye movements and double vision, painful movement in the jaw joint, do not say ‘oh, what’s the big deal, you can’t break a bone with a fall here’, these bones are as thin as membranes. and just the edge of a table can break those bones. Bone fractures heal in around 4 weeks. Bone fractures are usually operated on 3-4 days after the accident. At the time of fracture, it is very difficult to reach the bone because the tissues are extremely swollen. It is appropriate to wait and perform surgery after the swelling subsides. Patients are discharged 1 day after surgery and are prohibited from lying face down for 1 month. Operation scars are usually in areas that will not be visible just below the eyebrows or eyelashes in the hair, mouth. The operation time is usually around 2 hours. If the plaques cause pain in the future, they may need to be removed. In cases of possible suspicion of the patient or patient relatives, I recommend that the patient be examined by a plastic surgery doctor.