Multiple facial bone fractures

Case contributed by Dr Heather Pascoe


Backseat passenger in MVA with headstrike.

Patient Data

Age: 30 years
Gender: Female

Brain and Facial bones

  • No intracranial pathology.
  • Vitreous haemorrhage and likely globe rupture.
  • Mild proptosis.
  • Gas seen within the subcutaneous tissue overlying, and within the bony orbit.
  • Multiple facial fractures:
  1. Minimally displaced right zygomaticomaxillary complex fracture.
  2. Right maxillary antrum fracture involving all 4 walls including displaced anterior and medial wall fractures and extension into the alveolar process of the maxilla posteriorly.
  3. Right orbit fracture of 3 walls (sparing roof). No muscle entrapment in blowout floor fracture.
  4. Bilateral nasal bone fractures
  5. Possible anterior nasal septum fracture.

Case Discussion

The orbits should be a routine check area on all CT Brain studies. In this case there was obvious orbit injury clinically.

Complications of zygomaticomaxillary complex fractures include trismus due to impingement of the temporalis muscle and damage to the infraorbital nerve resulting in paraesthesia in its sensory distribution.

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Case information

rID: 32850
Case created: 18th Dec 2014
Last edited: 13th Feb 2018
Inclusion in quiz mode: Included

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