Look Me in the Face and Tell Me That I Needed to Be Transferred: Defining the Criteria for Transferring Patients with Isolated Facial Injuries [10.1097/TA.0000000000004651]

Dr. Bellal Joseph is the Martin Gluck Endowed Professor of Surgery, Professor of Neurosurgery, Chief of General Surgery and Chief Division of Trauma, Critical Care, Burns & Emergency Surgery, at the University of Arizona. He is also the Vice Chair of Research for the Department of Surgery.

Who are you getting specific Face CTs on?

Who are you getting temporal cuts on?

Radiology Tip: if there is no opacification of the maxillary sinuses, then the only fracture you will miss is a nasal bone fracture

Transfer if decreased visual acuity, diplopia, restricted ocular motility, retrobulbar hemorrhage, or comminuted fracture

May need drainage of septal hematoma

Easier to reduce nasal fractures when swelling goes down

Alveolar fracture doesn't preclude discharge

Here the complex refers to the components of the fracture pattern, not the complexity

aka quadripod fracture or quadramalar fracture

Transfer if diplopia or decreased visual acuity (On the show, we agreed, decreased ocular motility as well)

Transfer these fxs connote a high mechanism injury

Type I – Do not transfer

Type II/III – transfer

Do not transfer

Speak with consultants for malocclusion–depends on ability to get the pt in for follow-up

Transfer bilateral mandibular fractures or condylar fractures

Transfer if >2cm of flap defect or missing tissue, neurologic signs/symptoms, eyelid or glove laceration

Neuro signs and symptoms include loss of sensation, paresthesia, and facial muscle weakness

Some of these fractures and penetrating injuries can affect the auditory apparatus

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