to expose the fracture (C), which then can be repaired with plates and screws (D). (Illustration by GGS Inc.)
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OrbitAn orbital blow-out fracture consists of a fracture of the bones of the eye "socket". This may involve the orbital floor, walls, or roof. Most cases, however, involve the orbital floor. An orbital blow-out fracture is almost always secondary to a blunt blow from a relatively large object, such as a fist, elbow, baseball bat, or sever motor vehicle accident. Most patients will present with pain, tenderness around the eye, swelling, and double vision. Despite this potential for wide variation of internal orbital fractures, there are basic principles that can be applied to aid in diagnosis and treatment. The bony orbits play a vital role in maintaining normal function and aesthetics of the eyes therefore, realignment and reconstruction of the bony orbit of the eye is essential to maintain normal function and appearance of the eyes.
A number of advances have been made in the past 10 to 15 years in the diagnosis and treatment of internal orbital fractures. These advanced techniques have allowed for better exposure of the fractures and better exposure allows fore more precise reduction and stabilization of the fractures. The use of mini- or microplates and metal meshes in combination with bone grafts has also improved stabilization and enhanced the healing of orbital fractures.
Because most of the bone of the internal orbit is thin and weak, it is frequently difficult to reduce and adequately stabilize without the use of autogenous or alloplastic materials.
- Autogenous bone grafts have been the material most often used by craniomaxillofacial surgeons for reconstruction of the internal orbit. Split skll bone has gained popularity because of its low rate of infection and decreased resorption. Other autogenous materials that have been used include bone from the hip (iliac crest) and ribs or from cartilage.
- A variety of alloplastic material such as silicone, teflon, tantalum mesh, polyethylene, and methyl methacrylate have been used for orbital reconstruction. The primary concern with the use of these materials is the risk of infection. More Facial Trauma & Facial Reconstructive Surgery Facts...
MandibleThe mandible is a unique bone having a complex role in both aesthetics of the face and functional occlusion (bite). Because of the prominent position of the lower jaw, mandible fractures are the most common fracture of the facial skeleton.
Fractures of the mandible will typically reveal a malocclusion (inability to bite down), pain at fracture site, significant internal bruising, or laceration with bleeding between teeth at the fracture site.
Reduction and stabilization of the mandible fracture is the key to successful treatment. The method of management may vary based on the severity, location of the fracture and presence or absence of teeth. Mandible fractures are usually treated by closed reduction with wiring of the teeth or open reduction with internal rigid fixation using plates. Non-operative management of a mandible fracture with a soft diet is rarely indicated. The technique of closed reduction involves wiring the teeth for 4 to 6 weeks. Internal rigid fixation when performing open reduction requires exposure of the fracture sites and stabilization with plates and/or screws. Accurate reduction with good stabilization can frequently avoid complications and help to restore the patients primary occlusion and facial appearance. More Facial Trauma & Facial Reconstructive Surgery Facts...
Mandible stabilized with plate-and-screw fixation
Soft Tissue DeformitiesSoft tissue deformities may involve the skin, subcutaneous tissue, underlying muscle r a combination of any of these elements. Traumatic facial injuries may be blunt, penetrating and/or avulsive in nature. An avulsion, or loss of soft tissue, may create a significant deformity which requires reconstruction. Generally the facial bony deformities are reconstructed first followed by correction of soft