[Management of fractures of the face]

During 1985-1989, 371 patients with fractures of the lower two thirds of the facial skeleton were treated. Mean age was 31.2 years and there was a male prevalence of 78%. An equal distribution was found between fractures of the middle and lower third of the face. Our clinical experience has shown that it is preferable to start treatment as early as possible, using an open approach for reduction of fractures and rigid methods of fixation. Rigid internal fixation enables the patient to keep his jaws functional postoperatively and prevents the need for maxillomandibular fixation for 6 weeks. 6-month follow-up showed a low incidence of bone infection (1.5%), although most fractures were exposed to contaminated spaces. The major complication of treatment was impaired sensation of the lips and infraorbital regions (23%). In a follow-up of up to 1 year, the occurrence of this complication decreased to 7%.