A large percentage of the "traumatic" cases seen in the receiving ward of a general hospital are cases of acute facial injuries. Most frequently they occur in automobile accidents; next in frequency are those caused by a person being struck with a blunt object. A smaller number are due to knife or gunshot wounds.
It is best to manipulate and reduce fractures of the face as soon as possible, rather than wait a few days for ecchymosis and swelling to subside. When an accident case is first seen, it must be observed and treated for shock and bleeding. A thorough appraisal of the patient's general condition should be made, all appropriate specialty consultants being called in. An adequate airway must be assured, and if necessary a tracheostomy is in order. X-rays are taken in the receiving ward and antibiotics, antitetanus serum and any necessary supportive measures are administered.
SAFER LA. Acute Facial Injuries. Arch Otolaryngol. 1960;72(5):575–580. doi:10.1001/archotol.1960.00740010587002
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