Panfacial Fractures Management

Abstract

Introduction: Panfacial fracture represent a challenge for maxillofacial surgeons due to paucity of useful landmark and stable bone that can be used for fixation. Nowadays, with the availability of rigid and semi rigid fixations, understanding of the importance of the facial buttresses, bone grafting, and early intervention, the functional and cosmetic outcomes showed a significant improvement. Many treatment sequences exist in the literature including top to bottom, bottom to top, lateral to medial, and medial to lateral approach. Aim of the Study: To evaluate the outcome of “bottom to top, lateral to medial” sequence that we used in the management of panfacial fractures in term of function and cosmesis. Patients and Methods: This study included 73 patients with panfacial fractures admitted to the Maxillofacial and Plastic Surgery Department, Alexandria University. Results: Most of the patients (n = 52, 71.23%) were aged between 21 and 40 years old. 83.56% (n = 61) of patients were male. Road traffic accidents was the most common cause of trauma (n = 57). The most common site involved in panfacial fracture was the middle and lower third (58%). The common complication observed was malocclusion (n = 6). Of these, 5 patients had minor malocclusion that was corrected orthodontically and only one patient required surgical intervention. Conclusion: The “bottom to top, lateral to medial" sequence for reduction and fixation of panfacial fractures is reliable with satisfactory results in term of function and cosmesis.

Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries—A Novel Operation Method with the External Face Fixator

“…An image intensifier was not needed during the operation. The reduction could be performed using the occlusion as reference [ 19 ]. This was difficult in patients who were oropharyngeally intubated, as the tube hindered clinical control of a correct occlusion.…”

Risk factors for increased length of hospital stay among young pediatric patients who suffer facial fractures

“…Pan-facial fractures (fractures involving all thirds of the face) are often the result of high-impact injuries, namely MVA and gunshots. 17 Because facial fractures are less common in children, they may sustain life-threatening trauma when incurring pan-facial fractures. 18 Further, the treatment time may not increase linearly with each additional fracture, but rather exponentially since panfacial fractures often destroy facial landmarks that guide the reconstruction.…”

“…21 Further, MVA are a common cause of pan-facial fractures. 17,20 A study exploring pan-facial fractures among children presenting to an urban level 1 trauma center determined that the most common cause of injury was either a motor vehicle accident or being struck by a motor vehicle as a pedestrian. 20 Another study exploring the incidence and spectrum of facial fractures from MVA determined that over half the patients had multiple fractures.…”

Application of Virtual Reconstruction 3D-Printed External Fixation Helmet in Early Functional Treatment of Facial Fracture

“…The frontal zygomatic suture and zygomatic arch can be reset and fixed to obtain sufficient convexity and width. The zygomatic maxilla and piriform border and other lateral and medial skeletons can also be reset and fixed and the vertical pillars can be reconstructed to maintain the height [10] .…”