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There are 6 major areas/injuries to the face.

Basic Approach to Facial Injury

  • Step 1: Airway
    • Indications for intubation after trauma
      • Burns to the airway
      • Rapidly expanding hematoma
      • GCS <8
  • Step 2: CT Maxillofacial Without Contrast
  • Step 3: Supportive Care
    • Stop bleeding
      • Apply pressure
      • Control epistaxis
        • Caution advised with packing if patient has basilar skull fracture
    • Ice
    • Analgesics
  • Step 4: Antibiotics
    • Common indications
      • Fractures of a sinus
      • Open fractures
  • Step 5: Consider Consulting the Appropriate Specialist
    • Eye trauma -> Ophthalmology
    • ENT trauma -> ENT
    • Oral/Dental trauma -> Oral/maxillofacial surgery or dentistry

Six Key Facial Injuries

  • Frontal bone
    • Fractures of the INTERNAL frontal sinus wall = BAD
  • Eyes and orbits
    • “Blowout” fractures with entrapment of the extra-occular muscles = BAD
  • Nose
    • Septal hematoma = BAD
  • Zygoma (Cheekbone)
    • Zygomaticomaxillary complex fracture (aka Tripod fracture) = BAD
  • Maxilla (Upper jaw)
    • Le Fort fractures = BAD
  • Mandible (Lower jaw)
    • Open fractures (intraoral laceration) = BAD

Additional Reading