Welcome to the new Tamingthesru
Same great content - new look - improved search
Face the Music: Emergency Management of Facial Fractures
Maxillofacial trauma is common in the emergency department as ~80% of patients with polytrauma sustain injuries to the head, face, and/or neck. The most common etiologies of facial fractures are: assault (36%), motor vehicle accidents (32%), falls (18%), sports injuries (11%), occupational injuries (3%), and gunshot wounds (2%).3 The most commonly fractured facial bones are (in descending order): nasal bones, orbital floor, zygomaticomaxillary complex, maxillary sinuses, mandibular ramus, and the nasoethmoidorbital. This post will review the general approach to evaluation of maxillofacial trauma in the ED followed by specific management recommendations for various fracture patterns.
Antibiotics for Facial Fractures
In the Emergency Department, we frequently encounter patient's with facial fractures and associated lacerations. The orthopedic surgery literature strongly supports the use of antibiotics for open fractures. The facial surgery literature, however, does not have extensive publications addressing the use of antibiotics in open facial fractures. So what are we to do? Does every fracture get antibiotics? If not, which fractures?