Maxillary fracture in an elderly woman after a domestic fall

Abstract

Falls among older adults represent a major public health concern and are frequently associated with facial fractures, functional complications, and increased morbidity and mortality. This report describes the case of an 89‑year‑old female patient who suffered a fall from standing height while alone at home, resulting in facial trauma. She was taken to the Emergency Department of the Hospital de Clínicas de Campo Limpo Paulista, where she underwent clinical evaluation, detailed physical examination, facial palpation, ophthalmologic assessment, and computed tomography of the head and neck. Findings included significant facial edema, periorbital hematoma, and a maxillary bone fracture involving the maxillary sinus, without bone displacement. Therapeutic management of facial fractures in elderly patients remains a topic of debate, especially considering increased surgical risk, bone fragility, and comorbidities. In this case, conservative treatment was chosen due to the stability of the bone fragments, absence of significant functional impairment, and the patient’s advanced age. Clinical evolution was favorable, with gradual reduction of edema, resolution of the hematoma, and dequate bone healing without aesthetic or functional sequelae. This case reinforces the importance of individualized assessment in elderly patients with facial fractures, highlighting that the decision between surgical and conservative treatment must consider not only the fracture pattern but also the patient’s overall condition, anesthetic risks, and recovery potential. The non‑surgical approach proved effective, safe, and economically advantageous, reducing hospital costs and avoiding unnecessary surgical complications.