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:
- Simple—the bone is broken, but skin is intact
- Linear—the break is in a thin, straight line through the depth of the skull bone
- Depressed—the bone of the skull is crushed and pushed in toward the brain
- Comminuted—a complex fracture with bone splintering and tearing of the skin
Facial fractures can occur in any of the face’s bones. They are named for specific areas of the face:
- Maxillary fractures involve the upper jaw. They are classified as Le Fort I-V fractures based on their specific location on the maxillary bone.
- Mandible fractures involve the lower jaw.
- Zygomatic fractures involve the cheekbones.
- Orbital fractures involve the bones around the eyes
Fractures may either be:
- Closed—the fracture does not break the skin
- Open—the fracture breaks through the skin
Both skull and facial fractures may be life-threatening conditions. They require immediate medical treatment.
|Fractures in the Zygomatic Arch and Orbit|
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Skull and/or facial fractures are caused by direct trauma to the head. Trauma can be caused by:
- Car, motorcycle, or pedestrian accidents
- Blunt force trauma
- Penetrating trauma
- Domestic violence, or child or elder abuse
- Sports injury
Factors that may increase the chance of a skull and/or facial fracture include:
- Children up to 4 years old and older adults
- Not wearing a seatbelt
- Not wearing a bike or motorcycle helmet
- Occupations with risk of falls from heights
- Playing sports without proper head protection
- Health conditions that increase the risk of falls
Specific factors that may also increase a child’s risk of a skull fracture include:
- Previous head injury
- Wheelchair use
- Car seat related accidents, such as drops, flip-overs, or falls
These will depend on the location, type, and extent of the injury.
A skull or facial fracture may cause:
- Swelling and pain
- Visible bleeding (some injuries cause internal bleeding that may not be seen)
- Leaking clear cerebrospinal fluid, which usually occurs through the nose
- Blood in the ears or nose
- Inability to move face or mouth
- Uneven dental bite
- Eye problems, such as double vision or inability to completely move the eyes
- Breathing difficulties due to airway obstruction
- Hearing loss
- Numbness or tingling of the face
- Deformity or facial asymmetry
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:
- Any loss of consciousness
- Worsening headache
- Unequal pupils
- Increased pressure in the brain
- Paralysis to the limbs
Concussion may cause:
- Lightheadedness, which may lead to fainting
- Nausea with or without vomiting
- Changes in vision
- Sluggishness or grogginess
- Difficulty concentrating
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:
- Pain and airway assessment
- An examination of the ears for blood, and the nose for blood or fluid that may be leaking from the brain
- Glasgow coma scale—neurological exam that tests different parts of the nervous system including:
- Level of consciousness
- Pupil reaction to light
- Response to stimuli
Imaging tests may include X-rays and/or a CT scan.
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.
To help reduce your chance of a skull and/or facial fracture:
- Avoid situations that put you at risk of physical harm.
- Always wear a seatbelt when driving or riding in a car.
- Always wear a helmet when riding a bike or motorcycle.
- Do not drive under the influence of alcohol or drugs.
- Wear proper padding and safety equipment when participating in sports or activities.
To help reduce falling hazards at work and home:
- Clean spills and slippery areas right away.
- Remove tripping hazards such as loose cords, rugs, and clutter.
- Use non-slip mats in the bathtub and shower.
- Install grab bars next to the toilet and in the shower or tub.
- Put in handrails on both sides of stairways.
- Walk only in well-lit rooms, stairs, and halls.
- Keep flashlights on hand in case of a power outage.