Facial fractures

The common fracture patterns

Each one carries a distinct set of long-term consequences, and the consequences are what get undervalued.

• Orbital fracture — a blowout of the thin bone around the eye. Can cause double vision, a sunken eye, restricted eye movement, and permanent numbness of the cheek and upper lip
• Nasal fracture — the most common facial fracture. Frequently leaves a visible deformity plus obstructed breathing, which often needs surgical correction later
• Zygomatic or cheekbone fracture — flattening of the cheek contour, numbness, and sometimes trouble opening the jaw
• Mandible or jaw fracture — commonly treated by wiring the jaw shut for weeks, with lasting effects on bite alignment, chewing, and sometimes chronic TMJ pain
• Maxillary fractures — midface injuries that affect bite and facial height and typically require complex reconstruction
• Dental avulsion and fracture — teeth lost or broken, requiring implants that will need replacing over a lifetime

The consequences that get missed

Numbness is the most commonly overlooked. Facial fractures frequently damage the infraorbital or inferior alveolar nerve, leaving permanent numbness of the cheek, lip, or chin. It doesn't show in a photograph and it doesn't hurt, so it gets left out of claims — but it's permanent nerve damage that affects eating, speech, and shaving, and it's compensable.

How they happen, and who's responsible

Facial fractures most often come from vehicle crashes — including airbag deployment and steering wheel impact — assaults, falls, sports and recreational impacts, workplace incidents, and being struck by falling or ejected objects.