Facial & Skull Fractures

Let’s dive into the architectural marvel that is our face and skull.

Imagine an intricate mosaic, an artwork of bones interwoven with delicate precision. That’s our face – a grand symphony of 14 unique bones, each playing its part in crafting our distinctive facial features. From the robust mandible (jawbone) that forms the foundation, the twin maxillae creating the upper jaw and nose to the intricate zygomatic (cheekbones), and the elegant nasal bones – our face is a complex yet beautiful arrangement of skeletal structures.

Now, let’s travel north to the masterpiece of our bodily architecture – the skull. It’s not just a bone; it’s a fortress safeguarding our most valuable asset – the brain. The skull is akin to a well-fortified citadel, made of solid bone, sturdily designed to shield our brain from external harm. As we navigate through life’s adventures and perils, this bony helmet works tirelessly, offering a safe haven to our precious cerebral matter.

In this journey through the human body’s architecture, we see how our face and skull, though vastly different in their structure and function, work harmoniously to create our identity and protect us, truly a testament to nature’s ingenuity.Jake’s Story: The Mechanism of Injury

Jake, a local football player, suffered a heavy collision during a weekend match. As he attempted a spectacular dive to save a goal, he collided with an opponent, causing a significant impact to his face and head.

Types of facial fractures

• Jake’s Encounter with Facial Fracture: When the accident happened, Jake’s cheekbone took a severe hit. This resulted in what is known as a zygomatic fracture, one of the most common types of facial fractures. The zygomatic bone forms the prominence of the cheek, and fractures here can affect one’s appearance, vision, and ability to fully open the mouth.
• A Closer Look at Skull Fractures: The impact didn’t spare Jake’s skull, which was subjected to a harsh blow. The doctors identified it as a linear skull fracture – a crack in the skull that leaves the underlying tissues unharmed. However, all skull fractures carry a potential risk of injury to the brain, so Jake’s situation was closely monitored. Skull fractures can be categorized into four main types – linear, depressed, diastatic, and basilar, each requiring different levels of medical intervention based on severity and associated symptoms.
• Understanding Depressed Skull Fractures: Although Jake didn’t sustain a depressed skull fracture, it’s worth understanding what it entails. These fractures result in a part of the skull bone getting pushed inward, potentially pressing on or damaging the brain. This type of injury often occurs due to blunt force trauma, such as being struck with a heavy object.
• Diastatic Fractures – When Sutures Are Involved: Another type of fracture that Jake was fortunate to avoid is a diastatic fracture. This is when a fracture line transverses one or more sutures of the skull, causing them to widen. It’s more common in children whose sutures haven’t yet fully fused.
• Basilar Fractures – The Most Serious Skull Fractures: Basilar fractures involve a break in the bone at the base of the skull and are the most serious type of skull fracture. They often result in cerebrospinal fluid leak, which can manifest as visible fluid dripping from the nose or ears.

Despite the severity of Jake’s injuries, the types of fractures he sustained were the first steps to understanding his condition and formulating a plan to help him on his road to recovery.

Recognising Symptoms and Signs

• Extreme Facial Pain: One of the immediate complaints Jake vocalised was the extreme pain he felt in his face, specifically around his cheekbone area. This was a clear indicator of possible facial trauma, given the zygomatic bone’s vulnerability to fractures in high-impact facial injuries.
• Difficulty Opening the Jaw: As the team tried to keep Jake comfortable, he mentioned that he was struggling to fully open his jaw. This symptom, known as trismus, is often seen in patients with zygomatic fractures due to the bone’s proximity to the jaw joint.
• Blurry Vision: Jake’s vision was also affected. He reported seeing blurred images, which raised further concerns about possible injury to the eye socket or orbital floor – a complication that can occur alongside zygomatic fractures.
• Facial Swelling and Bruising: His teammates noted a growing swell and discolouration on Jake’s face, classic signs of a physical trauma that often accompany facial fractures.
• Feeling of Dizziness: Besides these symptoms linked to a facial fracture, Jake also experienced a sense of dizziness and disorientation. This raised alarms for a potential skull fracture as such symptoms can be indicative of a concussion or other forms of traumatic brain injury. Given the force of impact he endured, this was a plausible concern.

Each of these signs and symptoms painted a concerning picture, prompting Jake’s teammates to take immediate action and get him the urgent medical help he required.Examination at Urgent Care Brisbane

Upon arrival at Urgent Care Brisbane, the expert team immediately noted Jake’s symptoms. His physical examination revealed tenderness and deformity at the site of the facial injury. His neurological examination was closely monitored due to his potential skull fracture.

Investigations: X-ray and CT Scan

• Initial X-Ray Examination: Once Jake was brought into Urgent Care Brisbane, the team immediately used their on-site radiology services to conduct an X-ray of his face and skull. This preliminary step is crucial in visually capturing the presence and location of fractures.
• Detailed Assessment of X-Ray Results: The medical team scrutinised the X-ray results to identify any signs of facial or skull fractures. In Jake’s case, the image revealed damage to his cheekbone, indicating a zygomatic fracture.
• Computed Tomography (CT) Scan: Recognising the severity of the impact and Jake’s disorientation, the healthcare team escalated the investigation with a CT scan. A CT scan can provide a detailed, three-dimensional view of the bones and soft tissues, which is particularly beneficial for examining complex areas such as the skull and face.
• Evaluation of CT Scan: The CT scan allowed the doctors to look at Jake’s injury from various angles, helping to pinpoint the exact location and extent of his fractures. More critically, this imaging technique also helped rule out any potential brain injury, which is a critical concern with any skull fractures.

By utilizing both X-ray and CT scan imaging, the medical team at Urgent Care Brisbane were able to quickly and accurately assess Jake’s injuries, formulate an appropriate treatment plan, and ensure his safety throughout the process.