Malar Fracture


Malar Fracture

It is not unusual for people to suffer facial fractures after being involved in an auto accident. A malar fracture is a relatively uncommon injury in the medical world but is a common type of facial fracture. A malar fracture involves the fracture of one or more of the bones that make up the malar region of the face. These include:

  • The lateral orbital wall
  • The maxilla
  • The zygomatic arch
  • The orbital floor

The fracture will vary in size and severity. Some malar fractures will only damage one of these bones while a severe fracture will damage all of them.

How does this occur?

Patients will develop a malar fracture from any direct blow to the cheek area. In most cases, this occurs during an assault from a punch or blow to the face; however, it is easy to see how this can occur in a car accident as well. For example, if a car is T-boned in the driver’s door, the driver could very easily smash his or her cheek on the window. This could lead to a severe malar fracture.

How is this fracture treated?

This fracture will be classified as either non-displaced, angulated, or comminuted. The treatment will vary depending on the type of fracture.

Non-Displaced: A non-displaced fracture can still have multiple bones broken; however, none of these fractures is displaced out of line from its original position. The patient will be told to use caution as the fracture region will be tightly bandaged to ensure the bones do not displace.

Angulated or Comminuted: This could involve bones being displaced from their original position. If the bones are protruding through the skin, the fracture is called comminuted. This will require surgery to move the bones back into position. The bones may be held together with screws and plates.

Complications of a malar fracture

There are a number of complications that can develop from this fracture. One of the most common complications is called trismus, or difficulty moving the jaw, because many of these bones are adjacent to the jaw. Patients may also experience double vision, trouble seeing, or trouble moving the eyes (ophthalmoplegia) if the orbital wall is damaged. Patients could also develop infection if bacteria from the nose or mouth travel through the fractures into the soft tissue of the face.

What other structures are at risk?

Patients sustaining a malar fracture can damage other structures in the area as well. This can lead to secondary injuries that should be addressed. Examples include:

A detailed physical exam involving tests for motor and sensation will elucidate whether or not these structures are injured. If other bones and muscles are damaged, this will be addressed in surgery.

What else is on the differential diagnosis?

A malar fracture already has a relatively wide range of severity that encompasses multiple different types of fractures. The differential includes other fractures such as:

It is possible that a patient could have multiple or all of these fractures depending on the severity of the car accident.

What does the prognosis look like?

A malar fracture will generally heal with or without surgery. If the patient requires surgery, the plates and screws will remain in place for life; however, it is possible the patient could have some residual facial deformities depending on the success of putting the bones back together. If any nerves are damaged the motor or sensory function will be lost permanently.

Why does a patient require surgery?

A patient will require surgery for a malar fracture because the bones are out of place and need to be put back together. If the malar bones are out of place, the patient could have severe facial deformities along with damage to the orbital socket that makes it challenging to see. The surgeon will focus on restoring facial symmetry for aesthetic reasons and put the bones in contact with each other for the healing process.

West Sacramento Auto Accident & Personal Injury Lawyers

Hello, I’m Ed Smith, a West Sacramento Car Accident Lawyer. If you or someone you are close to has suffered a personal injury due to the negligence of someone else, call me promptly at (916) 921-6400 for free, friendly advice. If you are calling from outside the Sacramento region, please feel free to call me toll-free at (800) 404-5400.

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