Back to Previous Page

Skull and Facial Fracture

(Head Injury; Open Skull Fracture; Closed Skull Fracture; Fracture, Skull and Facial; Maxillary Fracture; Le Fort Fracture; Mandible Fracture; Zygomatic Fracture)

Definition

Skull and facial fractures are broken bones of the head and face. Injury can result in damage to the brain.
Types of skull fractures include:
Facial fractures can occur in any of the face’s bones. They are named for specific areas of the face:
Fractures may either be:
Both skull and facial fractures may be life-threatening conditions. They require immediate medical treatment.
Fractures in the Zygomatic Arch and Orbit
skull fracture zygo and eye socket
© Nucleus Medical Media, Inc.

Causes

Skull and/or facial fractures are caused by direct trauma to your head. Trauma can be caused by:

Risk Factors

Factors that may increase the chance of a skull and/or facial fracture include:
Specific factors that may also increase a child's risk of a skull fracture include:

Symptoms

These will depend on the location, type, and extent of the injury.
A skull or facial fracture may cause:
Some trauma causes bleeding in the brain. A hematoma occurs when a pocket of blood leaks into the spaces between the brain and the skull, increasing intracranial pressure. Signs of injury to the brain or hematoma include:
Concussion may cause:

Diagnosis

You will most likely be taken to a hospital. A doctor will ask about your symptoms and how your injury occurred. A physical exam will be done. A neurological exam will evaluate your nervous system. Tests may include the following:
Imaging tests may include X-rays and/or a CT scan.

Treatment

If you are in a situation where there is a skull or facial fracture injury, call for medical help right away.
Treatment will depend on the location and extent of the injury.

Stabilizing the Injury

The first steps will be focused on stabilizing your injury. They may include:
  • Attaching a backboard to stabilize the head and neck
  • A breathing tube for a blocked airway
  • IV fluids
  • Admission to the hospital for monitoring
Stabilization may also require emergency surgery to protect surrounding tissues and organs.

Initial Care

Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:
  • Without surgery—you will have anesthesia to decrease pain while the doctor moves the pieces back into place
  • With surgery—plates or wires may be needed to reconnect the pieces and hold them in place
Nearly half of skull and facial fractures require surgical repair. Surgery may not be done until the fracture is stabilized and swelling at the injury site goes down.

Hospitalization

People with these fractures usually need to stay in the hospital. Serious injuries may need to be watched in an intensive care unit. Some people with skull or facial fractures need to have help breathing. A tube is inserted and mechanical ventilation is used to protect and assist breathing.

Medications

You may need the following:
  • Pain medication
  • Antiseizure medications
  • Medications to reduce pressure inside your head or brain swelling
  • Antibiotics if an infection is present or possible

Rest and Recovery

Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it may take several weeks for a skull or facial fracture to heal.
You will need to adjust your activities while you recover, but complete rest is rarely required. Ice may also be recommended to help with discomfort and swelling.
As you recover, you may be referred to physical therapy or rehabilitation to keep your muscles strong. Do not return to activities or sports until your doctor gives you permission to do so.

Prevention

To help reduce your chance of a skull and/or facial fracture, take these steps:
To help reduce falling hazards at work and home, take these steps:

RESOURCES

American College of Emergency Physicians. http://www.acep.org

Brain Injury Association of America http://www.biausa.org

CANADIAN RESOURCES

Canadian Association of Emergency Physicians http://www.caep.ca

The Brain Injury Association of Canada http://biac-aclc.ca

References

Facial fractures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/head-neck/treatments-services/facial-fractures. Accessed September 29, 2014.

Maxillofacial injuries. Patient UK website. Available at: http://www.patient.co.uk/doctor/Maxillofacial-Injuries.htm. Updated December 20, 2010. Accessed September 29, 2014.

Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 4, 2014. Accessed September 29, 2014.

NINDS traumatic brain injury information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tbi/tbi.htm. Updated July 22, 2014. Accessed September 16, 2013.

Park CH, Lee JH, et al. Reduction of inferior orbital wall fractures using a Foley catheter and an endoloop. J Trauma. 2011;70(3):E38-E41.

Subdural hematoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 27, 2014. Accessed September 29, 2014.

Traumatic brain injury. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated March 6, 2014. Accessed September 29, 2014.

Revision Information