Current trends in the management of maxillofacial trauma

Management of maxillofacial trauma has developed in an evolutionary manner, with bursts of surgical creativity occurring during periods of war. Historical prospective of the knowledge which has been known for centuries, the various modalities of treatment developed over different times and how they have changed over the decades have been discussed: from conservative delayed operative repair, to an early aggressive one-stage approach; old principles of delaying surgery until the resolution of oedema, use of small incisions, minimal exposure of bony fragments, external pin fixations, intra-osseous wiring, prolonged intermaxillary fixation and minimal attention to primary soft tissue management have been changed. With contributions from Rowe and William, Tessier, Peterson, Fonseca and Walker and others, the new principles evolved are: the early one stage repair; exposure of all displaced fracture fragments; precise anatomic rigid fixation, immediate bone grafting, if required and definitive soft tissue management, allowing for better return of patients to their pre-traumatic appearance or at least as close as possible.