Treatments / Oral & maxillofacial surgery
Facial Trauma & Jaw Fractures
Dr Kuchu's specialist training is in the surgical management of facial injury: fixation of jaw and facial bone fractures, and repair of facial lacerations. At the clinic, within opening hours, Dr Kuchu does the assessment and first aid for facial injuries, and fracture fixation is done in hospital, where he works as a visiting consultant.
Who this is for
- A suspected broken jaw or cheekbone after a fall, sport or a road accident
- A facial cut needing careful repair
- A tooth knocked loose or out of position by an injury
What actually happens
- Examination and imaging to establish what is broken and how it has moved
- Immediate care: splinting, wound repair, pain control
- Where fixation is needed, it is done in hospital under general anaesthetic
What to do straight after a facial injury
Go to a hospital emergency department first if the person was knocked out even briefly, is vomiting, confused or unusually drowsy, has difficulty breathing or swallowing, has bleeding that does not stop with firm pressure, or has double vision or any change in their sight. After a fall or a road accident, if there is any neck pain, keep the person still and call 108 for an ambulance rather than moving them yourself. Call 108 too if they are struggling to breathe or are not fully awake.
If none of that applies, sit up and lean slightly forward so blood drains out of the mouth rather than down the throat. Press a clean cloth on any cut, hold a cold pack wrapped in cloth against the swelling, and if the cheek or the area around the eye was hit, do not blow your nose.
Then get seen the same day if your teeth no longer meet the way they did, part of your lip, chin or cheek has gone numb, you cannot open your mouth fully, or one cheekbone looks flatter than the other. These point to a fracture rather than a bruise. Call the clinic before you come so you know when you can be seen. If it is closed, or you cannot be seen that day, go to a hospital emergency department rather than waiting for the morning.
Where fractures are fixed
Where a broken bone has moved out of place, it is put back and held with small titanium plates and screws. For the jaw this is usually done from inside the mouth, so there is no cut on the face. Some cheekbone and eye-socket fractures need a small cut on the skin, and the surgeon will explain where.
This is done under general anaesthetic in hospital. Dr Kuchu is a visiting consultant maxillofacial surgeon at Bhoomi Hospitals, Manikonda; Madhavanji Hospitals, Tukkuguda; Kondeti Hospital, Tukkuguda; and Wellness Hospitals, Begumpet, and you are told which hospital before admission. The clinic has no operating theatre, so examination, first aid and follow-up happen at the clinic, and the fixation in hospital.
Fixation is not always done on the day of the injury. Swelling, other injuries and how fit you are for an anaesthetic all affect the timing, and Dr Kuchu will explain the plan once he has seen your scans.
Recovery after a jaw or cheekbone fracture
Bone usually takes several weeks to heal, and until then it is a soft diet and no contact sport. Swelling and bruising are usually worst in the first few days and fade over the next couple of weeks.
Keep the mouth clean while it heals, because food collects around stitches and plates. You come back to the clinic for reviews, and an X-ray or scan is often repeated to check that the bone is healing in position.
Numbness of the lip, chin or cheek is common after these fractures. It often improves over weeks to months, though it does not always recover fully, so mention any change at your reviews.
After an injury the first hour matters. What to do in the first hour covers a knocked-out or broken tooth, and the signs that point to a fracture rather than only a damaged tooth.
Questions people ask
How do I know if my jaw is broken?
Typical signs are teeth that suddenly do not meet properly, pain when you bite or open your mouth, swelling, and numbness of the lower lip or chin. Only an examination and an X-ray or scan can confirm it, so get seen the same day.
Can a broken jaw heal without surgery?
Sometimes. A fracture where the bone has not moved can often be managed with a soft diet, rest and close review. Bone that has shifted out of place usually needs to be put back and held.
Do the plates have to come out later?
Usually not. They are small titanium plates that are normally left in place, and they are only removed if they cause a problem such as infection or irritation.
Should I go to a hospital or see a maxillofacial surgeon after a face injury?
Go to hospital first if there is any sign of head injury, difficulty breathing, heavy bleeding or a change in vision. Otherwise, an oral and maxillofacial surgeon is the right person to check the jaw and facial bones, so call the clinic during opening hours.
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