Facial trauma service overview

Causes and Types of Facial Bone Fractures

Facial bone fractures can occur due to various reasons, with interpersonal violence, sports injuries, and road traffic accidents being the most common. A ‘simple crack’ in the bone might not require fixation and can heal independently. However, displaced fractures often need realignment and fixation using small titanium bone plates and screws.

Symptoms indicating a facial bone fracture may include:

  • Painful or abnormal bite, suggesting jawbone fractures
  • Numbness of the cheek, bright red eye white, nose, or top lip, indicating a fractured cheekbone
  • Nosebleed or a deviated nose, pointing to a nasal bone fracture
  • Crunchy noises when moving the jaw, which may indicate a fracture in the jawbone or jaw joint

Management of Subacute Fractures in Private Healthcare

In private healthcare, where I exclusively work, I manage subacute fractures that do not require fixation within 72 hours. A CT scan is typically necessary to confirm the diagnosis and fully characterize the fracture’s extent.

Example: A 3D scan showing a fracture of the right cheekbone, with a vertical line running from the right eye socket down to the top jaw.

Emergency Referrals to Public Health Services

Private healthcare does not offer out-of-hour specialist services, and all emergencies are directed to public health services. I do not provide acute services, so any of the following cases should be referred to the nearest appropriate emergency department:

  • Active bleeding
  • Acute airway injury or compromise
  • Associated intracranial injury
  • Reduced or deteriorating consciousness
  • Immediate admission required for lower jaw fractures
  • Very swollen, tense, painful, and blurry eye (indicating bleeding behind the eyeball)
  • Facial skin or oral mucosal lacerations needing repair within 24 hours

Optimal Timing for Fixing Displaced Fractures

Many displaced fractures, such as those of the cheekbone, skull, or nose, are best fixed within 7 to 10 days to allow swelling and bruises to settle.

Referral and Management Process

I accept referrals for fractures that meet the above criteria. Most of these patients are managed under ACC, meaning private insurance or self-payment is not necessary.

For consultations or further information, please contact us. Our practice manager will assist with any questions and help schedule a consultation.

Where to Refer?

Private:
Auckland Head & Neck Specialists, MercyAscot,
100 Mountain Road Epsom.
E-mail: info@ahns.co.nz

Greville Dental (Visiting Surgeon), 18 Hauraki Crescent, Pinehill. E-mail: info@ofhnsurgery.co.nz