Panfacial Bone Fracture and Medial to Lateral Approach

Kim, Jiye; Choi, Jaehyung; Chung, Yoon Kyu; Kim, Sug Won

doi:10.7181/acfs.2016.17.4.181

Cited by 25 publications

(32 citation statements)

References 16 publications

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“…Recently, there is a decreasing trend in facial trauma related to TA in many developed countries because of the strengthening of traffic safety regulations. For this reason, interpersonal violence has shown to relatively increase as an important cause [8][9][10]. In recent studies, the most frequent cause of injury was assault, followed by falls, sport accidents, TA, work accidents, and other causes [11].…”

Section: Discussionmentioning

confidence: 99%

Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p < 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

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Section: Discussionmentioning

confidence: 99%

Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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“…La evaluación y el tratamiento de las fracturas panfaciales puede ser un desafío clínico, ya que involucra simultáneamente huesos de dos o más tercios faciales, en las que el grado de fragmentación dificulta la restauración de la arquitectura original facial (Kim et al;Wang et al, 2019). Además, suelen estar asociadas a lesiones de columna cervical y/o craneocerebrales y obstrucción de la vía aérea, arriesgando así la vida del paciente (Yang et al).…”

Section: Discussionunclassified

“…Las fracturas panfaciales se definen como aquellas fracturas que afectan de forma simultánea a dos o más tercios del rostro (Yang et al, 2012). Suelen ser causadas por traumatismos de alta energía cinética (lesiones por accidentes de tránsito o traumatismos por impacto balístico) y representan entre el 4% y el 10% de todas las fracturas faciales (Kim et al, 2016). Por lo general ocurren en forma concomitante a otras lesiones que pueden comprometer la vía aérea del paciente o estar asociadas a lesiones intracraneales y de la columna cervical, de manera que es fundamental tener en consideración el manejo inicial del trauma: control de la vía aérea y columna cervical, respiración, circulación, valoración del estado neurológico y exposición y control ambiental (ABCDE) para la estabilización del paciente (Chukwulebe & Hogrefe, 2019).…”

Section: Introductionunclassified

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Mardones-M

Bravo-A

Fernández-T

et al. 2020

Int. J. Odontostomat.

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RESUMEN: Las fracturas panfaciales son aquellas que afectan de forma simultánea al tejido óseo de dos o más tercios del rostro. El manejo inicial de estos pacientes es resolver o estabilizar las urgencias médico-quirúrgicas que puedan presentar, debido a que la gran mayoría de estas fracturas están asociadas a traumatismos de alta energía cinética, las que determinan la presencia de lesiones concomitantes que pueden comprometer la vida del paciente. El tratamiento quirúrgico de las fracturas panfaciales puede abarcar desde la intervención quirúrgica inicial de control de daños, estabilización, reducción y fijación quirúrgica de los segmentos fracturados mediante osteosíntesis hasta intervenciones mediatas para la reconstrucción de los tejidos afectados por el traumatismo. Para el tratamiento de las fracturas panfaciales existe una sistemática quirúrgica que tiene por objeto contener y/o minimizar daños agudos y permitir una reducción morfológica y funcional. Reportamos un caso clínico de fractura panfacial cuyo tratamiento siguió esta sistemática terapeútica. PALABRAS CLAVE: fractura panfacial, politraumatizado, manejo inicial del trauma.

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“…[ 15 16 17 ] To achieve functional and esthetic outcome and prevent these psychosocial symptoms, there must be sequencing in the repair of this complex region. [ 1 18 ] Several sequencing approaches have been mentioned in the literature to include “bottom-up,” “inside-out,” “outside-in,” and “top-bottom” approach. [ 1 18 19 ] However, the ideal sequencing of a complex panfacial fracture remains the greatest challenge to every oral and maxillofacial surgeon.…”

Section: Introductionmentioning

confidence: 99%

“…[ 1 18 ] Several sequencing approaches have been mentioned in the literature to include “bottom-up,” “inside-out,” “outside-in,” and “top-bottom” approach. [ 1 18 19 ] However, the ideal sequencing of a complex panfacial fracture remains the greatest challenge to every oral and maxillofacial surgeon. [ 18 ]…”

Section: Introductionmentioning

confidence: 99%

Experience with airway management and sequencing of repair of panfacial fractures: A single tertiary healthcare appraisal in Najran, Kingdom of Saudi Arabia - A retrospective study

Daniels

Albakry

Braimah³

et al. 2020

Ann Maxillofac Surg

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Introduction: Special cooperation is required among surgeons and anesthetists in airway management during repair of panfacial fractures, due to problems of shared airway and occlusion. Several methods have been proposed for airway management and sequencing of repair of panfacial fractures. The main objective of the current study was to share our experience in the airway management and sequencing of repair of panfacial fractures. Methods: This was a retrospective study of panfacial fractures in the Kingdom of Saudi Arabia from January 2008 to December 2018. Data collected included demographics, type of airway management, sequence of repair (as primary variables), and outcome of surgery (secondary variable), while surgeon and anesthetic expertise are confounders. Data were analyzed using IBM SPSS Statistics for Windows Version 25 (Armonk, NY, USA: IBM Corp). Results were presented as simple frequencies and descriptive statistics. Pearson Chi-square was used to compare categorical variables such as airway management and sequencing of repair with the panfacial fractures. Statistical significance was set at P ≤ 0.05. Results: Overall, 1057 patients sustained different categories of maxillofacial bone fractures with 23 females and 1034 males (M:F of 46:1). A total of 43 male patients out of 1057 patients had panfacial fractures during the study period, giving a prevalence rate of 4.1%. Only the 43 male patients with panfacial fractures were analyzed. All cases were as a result of motor vehicular accident. Six (13.9%) patients had tracheostomy while 37 (86.1%) patients had submental intubation. “Bottom-up” and “outside-in” approach was used in 33 (76.7%) patients, while “top-bottom” and “inside-out” approach was used in 10 (23.3%) patients. Discussion: Submental intubation was the major airway management of panfacial fracture, and “bottom-up” and “outside-in” approach was the main sequence of repair in our series. These approaches have been mentioned in the literature. Conclusion: From our study, victims of pan-facial fractures were found to be exclusively male with MVA as the sole etiological factor. Barring severe head injuries, which may necessitate the use of tracheostomy to sustain breathing over a longer period, submental intubation is extremely reliable as a mode of airway management during surgical treatment of panfacial fractures. The sequencing of repair of panfacial fractures can only be determined according to the case presentation rather than a predetermined one.

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Panfacial Bone Fracture and Medial to Lateral Approach

Cited by 25 publications

References 16 publications

Trauma severity and mandibular fracture patterns in a regional trauma center

Trauma severity and mandibular fracture patterns in a regional trauma center

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Experience with airway management and sequencing of repair of panfacial fractures: A single tertiary healthcare appraisal in Najran, Kingdom of Saudi Arabia - A retrospective study

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