FACIAL BONE FRACTURES AND AESTHETICS
Facial bone fractures occur due to many reasons such as traffic accidents, blows, falling from heights. The most frequent fractures are in the nose, jaw, and cheekbones. Following the trauma, these manifest themselves with symptoms such as facial swelling, bleeding, difficulty in opening the mouth, inability to close the teeth, limitation of eye movements, and stepping in the jaw bones. In some cases, the patient does not have any complaints and fractures can be detected during routine radiological examinations.
In individuals who are thought to have fractures in the face or jaw bones, the first thing to do is to evaluate the airway clearance. Next, radiography and computed tomography are used to determine the fracture line and operation is planned.
In facial bone fracture operations, usually the fracture line is introduced, broken ends are placed side by side and fixed with the plate-screws. In some fractures of the cheekbones, the collapsed bone is lifted through a small incision made from the temple. In some cases, the situation called greenstick fracture is encountered. In this case, although the bones are broken, they still stand end-to-end together. In these cases, the upper and lower jaws are connected to each other with wires in order to prevent the opening and closing of the mouth. If adequate bone fusion is observed after 4-6 weeks of fixation, the mouth is opened by removing the wires.
After fixing with plate-screw, it is not necessary to remove these screws except for children up to the adolescence period. If the melting plaques are not used in children, the plaques should be removed after an average of 4 weeks in order to avoid the growth of the jaw.
In facial bone fracture operations, patients should have a good oral care. In case of an incision through the mouth, it is necessary to avoid solid foods for the first 2 weeks in order to prevent infection. Mouthwashes and antibiotics must be used postoperatively. Persons, who are prescribed for long-term fixation or who are expected to have limitations in their mouth movements, due to the nature of the fracture, should be directed to physiotherapy postoperatively.
The lower jawbone called mandibular should be mentioned separately from the joint region fractures. The general tendency is to restrict the mouth movements by fixing the jaws to each other after closed fixing of these fractures. Open surgery is applied in limited cases, because of the risk of facial paralysis.