Facial Fracture Repair Petoskey
INSTRUCTIONS
This is an informed consent document that has been prepared to help inform you concerning facial injury/fracture repair surgery, its risks, and alternative treatment.
It is important that you read this information carefully and completely. Please initial each page, indicating that you have read the page and sign the consent for surgery as proposed by your plastic surgeon.
INTRODUCTION
Injury to the face and facial bones can produce damage to both the skin and the deeper boneyl structures. Nasal bones and the nasal septum (the wall-like structure in between the nostrils) can be fractured or disrupted as can the facial skeleton which supports the eyeballs and the teeth. Depending on the extent of injury, other structures within the face may require treatment as well. Some facial injuries may be very minor and not require operative treatment. Surgical treatment of facial injury/fracture is performed to repair soft tissues or damaged structures such as broken nasal bones, or to replace and plate broken bones. Facial fracture repair surgery is intended to minimize potential deformities due to abnormal healing of displaced boney structures-left untreated they can result in functional and cosmetic impairments.
Nasal injury repair surgery is most frequently performed using a closed technique in which skin incisions are not necessary. Nasal bones can be elevated and the nasal septum straightened. If the fracture injury is more severe, incisions and more involved surgical techniques may be needed. This can involve using wires, plates and screws to fixate the bone. Surgery is performed under local or general anesthesia.
Timing of facial injury/fracture repair surgery is critical as facial bone fractures tend to heal quickly.
Nasal and facial injuries may create both visible, tactile and functional deformities involving the nose or the facial skeleton. Future reconstructive surgery may be necessary to treat residual deformities and functional problems of decreased nasal airway function, asymmetric positioning of the eyeball, impaired movement of the eyeball or misalignment or loosness of the teeth.
ALTERNATIVE TREATMENT
Alternative forms of treatment consist of not undergoing the facial injury/fracture repair surgery. Risks and potential complications such as the possibility of visible and palpable malformations and nasal airway, breathing problems, visual disturbances (eg.double vision), disturbed chewing ability, persistent numbness are associated with non-treatment of facial injury/fracture injuries.
RISKS of FACIAL INJURY/FRACTURE REPAIR SURGERY
Every surgical procedure involves a certain amount of risk and it is important that you understand the risks involved with facial injury/fracture repair surgery. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience the following complications, you should discuss each of them with your plastic surgeon to make sure you understand all possible consequences of facial injury/fracture repair surgery.
Nasal airway alterations- Changes that occur as a result of nasal injury that may interfere with normal passage of air through the nose. Additional surgery may be necessary to correct this problem. The nasal bridge may be deviated or develop a hump.
Bleeding- It is possible, though unusual, that you may have problems with bleeding during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to stop the bleeding or remove accumulated blood (hematoma). Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this contributes to a greater risk of bleeding. Non-prescription “herbs” and dietary supplements can increase the risk of surgical bleeding. Hypertension (high blood pressure) that is not under good medical control may cause bleeding during or after surgery. Accumulations of blood under the skin may delay healing and cause scarring.
Infection- Infection is quite unusual after surgery. Should an infection occur, additional treatment including antibiotics may be necessary. If plates get infected they may require surgical removal.
Scarring- Although good wound healing after a surgical procedure is expected, abnormal scars may occur both within the skin and the deeper tissues. Scars may be unattractive and of different color than the surrounding skin. There is the possibility of visible marks from sutures. Additional treatments including surgery may be needed to treat scarring. Eyelid closure or positioning may be adversely effected by excess scar development with healing and require surgery to correct.
Unsatisfactory result- There is the possibility of an unsatisfactory result from the facial injury/fracture repair surgery. The surgery may result in unacceptable visible or tactile deformities, loss of function, or structural malposition. You may be disappointed that the results of facial injury/fracture repair surgery do not meet your expectations. Future surgery may be necessary should the result of facial injury/fracture repair surgery be unsatisfactory. Partial healing of damaged structures prior to facial injury/fracture repair surgery may interfere with the optimal result from surgery.
Damage to deeper structures- Deeper structures such as nerves, tear ducts, blood vessels and muscles may be damaged during the course of surgery. The potential for this to occur varies with the type of procedure performed. Injury to deeper structures may be temporary or permanent.
Asymmetry- The human face is normally asymmetrical. There can be a variation from one side to the other in the results obtained from a facial injury/fracture repair surgery.
Numbness- There is the potential for permanent numbness within the skin after facial injury. The recovery of this numbness is not predictable. Diminished (or loss) of skin sensation in any facial structure may not totally resolve after nasal injury.
Chronic pain- Very infrequently, chronic pain may occur after facial injury or fracture.
Hardware and deeper sutures- Some surgical techniques use small screws, metal plates, or wire sutures to help stabilize damaged nasal structures. These items may be noticed by the patient following surgery. It may be necessary to remove these at a later time.
Patient compliance- Patient compliance with post-operative activity restriction is critical. Personal and vocational activities that involve the potential for re-injury to the facial region must be avoided until healing is completed.
Allergic reactions- In rare cases, local allergies to tape, suture or plating material, or topical preparations have been reported. Systemic reactions which are more serious may result from drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.
Delayed healing- Fracture disruption or delayed healing is possible. Some areas of the nose or jaws or orbits may heal abnormally or slowly. Areas of skin may die and may require frequent dressing changes or further surgery.
Long-term effects- Subsequent alterations in facial appearance may occur as the result of aging, sun exposure, or other circumstances not related to facial injury repair surgery. Future surgery or other treatments may be necessary.
Nasal septal perforation- Infrequently, a hole in the nasal septum will develop. The occurrence of this is rare. Additional surgical treatment may be necessary to repair the nasal septum. In some cases, it may be impossible to correct this complication.
Surgical anesthesia- Both local and general anesthesia involve risk. There is the possibility of complications, injury, and even death from all forms of surgical anesthesia or sedation.
HEALTH INSURANCE
Most health insurance companies cover surgical operations to treat acute facial injuries. Coverage for future reconstructive procedures following facial injuries can vary, depending on your health care insurance company’s policies. Please carefully review your health insurance subscriber-information pamphlet.
FINANCIAL RESPONSIBILITIES
The cost of surgery involves several charges for the services provided. The total includes fees charged by your doctor, the cost of surgical supplies, anesthesia, laboratory tests, and possible outpatient hospital charges, depending on where the surgery is performed. Depending on whether the cost of surgery is covered by an insurance plan, you will be responsible for necessary co-payments, deductibles, and charges not covered. Additional costs may occur should complications develop from the surgery. Secondary surgery or hospital day surgery charges involved with revisionary surgery would also be your responsibility.
ADDITIONAL SURGERY NECESSARY
There are many variable conditions in addition to risk and potential surgical complications that may influence the long term result from facial injury repair surgery. Even though risks and complications occur infrequently. The risks cited are particularly associated with facial injury repair surgery. Other complications and risks can occur but are even more uncommon. Should complications occur, additional surgery or other treatments may be necessary. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied as to the results that may be obtained. It may be necessary to perform additional surgery to improve your results following facial injury.
DISCLAIMER
Informed-consent documents are used to communicate information about the proposed surgical treatment of a disease or condition along with disclosure of risks and alternative forms of treatment(s). The informed-consent process attempts to define principles of risk disclosure that should generally meet the needs of most patients in most circumstances.
However, informed consent documents should not be considered all inclusive in defining other methods of care and risks encountered. Your plastic surgeon may provide you with additional or different information which is based on all the facts in your particular case and the state of medical knowledge.
Informed-consent documents are not intended to define or serve as the standard of medical care. Standards of medical care are determined on the basis of all of the facts involved in an individual case and are subject to change as scientific knowledge and technology advance and as practice patterns evolve.