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Facial Trauma

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Sports-related Fractures, Dislocations and Trauma

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Abstract

Facial trauma encompasses some of the most common and visually striking injuries that occur in sports. The extent of these injuries, however, is difficult to estimate secondary to the breadth of conditions included in this category, popularity of sports in a given locale, and the wide variations in reporting such cases. The face itself is an anatomically complex region, technically defined by the borders of the hairline to the ears superiorly and laterally extending to the jaw inferiorly. It is estimated that anywhere between 3% and 40% of sports-related injuries involve the face. Furthermore, up to 8% of all soft tissue injuries involving the face occur during sports-related activities. There is a virtual cornucopia of maladies that are contained in the realm of facial trauma, including fractures (e.g., nasal, zygoma, mandible, and others), dental avulsions, cartilage lacerations (e.g., ears and nasal), septal hematomas, and ocular trauma. Furthermore, these injuries often occur in conjunction with one another (e.g., a nasal fracture and a septal hematoma). An optimally prepared team or sideline physician should be well prepared to assess facial trauma, treat when appropriate, refer for further evaluation when indicated, and be familiar with the return-to-play guidelines associated with these conditions. This chapter aims to aid the sideline provider in achieving these objectives.

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Notes

  1. 1.

    From a technical standpoint, orbital and nasal fractures are also included in the category of maxillofacial or midface fractures. However, given their associated unique evaluation and treatment considerations, they have been given their own sections in this chapter.

  2. 2.

    As previously stated, there have been no reports of vasoconstrictor-induced tissue necrosis attributed to lidocaine with epinephrine since 1948. We contend that this is a safe medication in the nose (among other anatomic sites), which is also supported by Marston et al. [67].

  3. 3.

    Some dental texts have extended the Ellis classification through Ellis IX injuries. This further delineation of dental trauma past an Ellis V is beyond the scope of this chapter, and such injuries should warrant immediate evaluation by a Dentist or Oral Surgeon.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Christopher Hogrefe MD, FACEP, CAQ-SM

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  1. Christopher Hogrefe MD, FACEP, CAQ-SM
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  1. Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, CO, USA

    Morteza Khodaee

  2. Department of Emergency and Sports Medicine, The University of Arizona, Tucson, AZ, USA

    Anna L. Waterbrook

  3. Vermont Orthopedic Clinic, Rutland, VT, USA

    Matthew Gammons

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Hogrefe, C. (2020). Facial Trauma. In: Khodaee, M., Waterbrook, A., Gammons, M. (eds) Sports-related Fractures, Dislocations and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-36790-9_44

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