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Craniofacial injuries can occur in a significant proportion in traumatic brain injury patients and can be associated with many other concomitant life-threatening systemic injuries i.e. limbs fractures, chest injuries, spinal injuries and orbital injuries. An understanding of the presentations of craniofacial injuries, associated systemic injuries and patterns of traumatic brain injuries is crucial for improving care, survival and recovery of these patients. In present article we discuss the approach to craniofacial injuries which is based on time tested principles of surgery a good understanding of surgical anatomy, detailed history, accurate yet elaborative clinical evaluation, appropriate radiological investigations and decision to select management protocol for a given case. Evaluation of these patients should include a coordinated and systematic examination to aim to evaluate of all areas and all the residents while examining these patients in emergency room should remember that facial swelling, altered sensorium, restless patient, presence of endotracheal and nasogastric tube can obscure the detail examination and distort the facial appearance.

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Introduction:The management of facial trauma is one of the most important and demanding aspects of maxillofacial surgery. Mandible is the most movable and prominent bone of facial skeleton. The management of the injuries to the maxillofacial complex remains a challenge for oral and maxillofacial surgeons. The aim of mandibular fracture treatment is the restoration of anatomical form and function with particular care to establish occlusion. The lag screw technique was fi rst introduced to maxillo facial surgery by Brons and Boering in 1970, who cautioned that at least two lag screws are necessary to prevent rotational movement of the fragments in oblique fractures of mandible.