Facial Injury : Contusion
This injury refers to bruising of the soft tissues [other than bone] of the face. Contusions often cause the familiar "black and blue area," which is caused by bleeding beneath the skin. One of the most commonly recognized facial contusions is the "black eye" (periorbital contusion). Common symptoms of facial contusions include pain and swelling at the site of the injury. Contusions around the eye (periorbital contusions) often cause the eye to close due to swelling. In this instance, the eye may require antibiotic drops to prevent infection. Any associated neck pain should make the patient
suspicious of neck fracture.
Evaluation will include x-rays of the face to the possibility of facial fracture. Examination of the eyes, ears, jaw, teeth, and facial bones will be performed by the physician. Any malfunction of jaw movement, hearing, or vision must be evaluated promptly. Unusual swelling, deformity, or asymmetry to the facial contour can indicate facial fracture. The finding of crepitation or of a spongy texture of the skin can indicate fracture to a sinus cavity. Double vision, due to the inability to move the eyes evenly in all directions, also indicates a more serious injury.Treatment of a facial contusion is with cold compresses and analgesics such as acetaminophen or ibuprofen. Aspirin should be avoided as it tends to promote bleeding. Initial discoloration will be "black and blue" turning to a green-yellow, as healing occurs over 1 to 2 weeks. Contusions around the eyes often result in discoloration (black eyes). This is of no added concern. The development of "black eyes" after a head injury (no direct injury to the face), should make one suspect the possibility of a skull fracture.
REMEMBER
Any facial injury resulting in NECK PAIN should be evaluated for neck fracture. Any facial injury, with associated loss of consciousness, must be evaluated as a head injury.
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