[Management of craniofacial fractures with titanium mini-plate osteosynthesis and primary bone transplantation]

The frontobasal traumatic lesions are often combined with several type of midface fractures therefore the authors adopted the craniofacial injury definition. In the years 1995-1997, 534 patients with head trauma were operated on by maxillofacial surgeon and neurosurgeon of which 35 (6.5%) cases showed concomitant combined frontonaso-orbital-skull base involvement. In the complex management of the severe craniofacial lesions the cooperative team-work of maxillofacial surgeon, neurosurgeon, otolaryngologist and ophthalmologist is required. Stabilized midface and the "watertight" dura closure or plasty are basically important conditions for the ceasing of cerebrospinal fluid leak. In the instance of optic nerve lesion the exploration and decompression within the eight hours is mandatory by transcranial-subcranial approach. At their cases authors preferred the early, definitive one-stage management with step-by step titanium miniplate reconstructive osteosynthesis and primary bone grafting correct bony restoration could be achieved. According their experiences of new treatment method with definitive one-stage management of complex craniofacial injuries they decreased the incidence of postoperative complications, the time of hospitalisations obtained optimal functional and cosmetic results.