ce and function in a one-stage operative repair. However, despite many surgical advances, there are still patients that end up with significant deformities. These are patients that for whatever reason are treated inadequately or because of other life-threatening injuries, cannot receive treatment of their facial injuries.
Facial reconstruction following trauma
Surgery following facial trauma may take as long as four to 14 hours, as the goal is to repair as much as possible in one operation. The surgeon may use bone grafts, taking bone from other parts of the body to repair the facial bones, or fill in smaller areas of missing bone with prosthetic materials and implants. Broken facial bones are held in place with titanium mini-plates and surgical screws. This technique is called rigid fixation. Lacerations (tears) in the face are usually simply closed with stitches. If large areas of skin are missing, the surgeon may use a flap, which is a section of living tissue carrying its own blood supply, from another area of the patient's body and transplant it to the face. Some facial injuries may require the assistance of a neurosurgeon, oral surgeon, or ophthalmologist. More Facial Trauma & Facial Reconstructive Surgery Facts...
Common bony injuries to the face following facial trauma
ZygomaThe location of the zygoma makes it prone to injuries despite its sturdiness. The zygomatic bone occupies a prominent and important position in the facial skeleton. It plays a key role in determining facial width as well as acting as a major support of the midface. The mechanism of injury usually involves a blow to the side of the face from a fist, object, or motor vehicle accidents. Moderate force may result in minimally or nondisplaced fractures. More severe blows result in displacement of the zygoma.
Historically, zygomatic fractures were fixed by popping the fragments back into alignment (closed reduction). Not only were these results frequently unsatisfactory, but they were also fraught with complications including visual problems, non healing of the fracture, and significant residual deformities. The treatment of zygomatic fractures has dramatically progressed over the past several decades to the more aggressive open repair using rigid mini-plates of technetium to stabilize a fracture and align the bones in their appropriate position (open reduction). The floor of the orbit (eye socket) is routinely explored and reconstructed, if needed. More Facial Trauma & Facial Reconstructive Surgery Facts...
MaxillaThe maxilla is the largest part of the middle third of the facial skeleton. Fractures of the maxilla occur less frequently than those of the mandible or because of the strong structural support of this bone. The midface consists of alternating thick and thin sections of bone that are capable of resisting high amounts of force. This structurally strong bone provides protection for the eye socket and brain, projection of the midface, and support for the upper bite.
Maxillary fractures today are often the result of motor vehicle accidents. These high-velocity injuries are diagnosed by computerized tomographic (CT) scans. Once again, the more recent development of 3-D reconstructions have aided greatly in the diagnosis, classification, and preoperative planning of these complex maxillary fractures.
Maxillary fractures are treated by realignment and immobilization of the bones that make up the maxilla. Establishment of pre-injury bite and midface alignment provides the foundation for this treatment. Early placement of the patient in Internal Maxillary Fixation (IMF) will decrease the chance of Internal Soft tissue deformities. IMF is established by securing wire arch bars to the upper and lower set of teeth. The appropriate occlusion of the teeth (or bite) is then determined and the maxillary and mandibular (jaw bone) arch bars are secured together. This is one of the simplest and most effective forms of treatment.
Recent advances in the treatment of maxillary fractures include the use of open-repair and realignment (open reduction) technique