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Assessment of Bone Fracture Healing Using Micro-Computed Tomography
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Panfacial bone fracture: cephalic to caudal
1Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea.
Archives of Craniofacial Surgery
|April 4, 2018
Summary
Panfacial bone fractures, often involving two or three facial areas, require open reduction and internal fixation. Surgical sequencing, prioritizing facial width, yields acceptable outcomes for these complex facial fractures.
Area of Science:
- Oral and Maxillofacial Surgery
- Trauma Surgery
- Plastic Surgery
Background:
- Panfacial bone fractures theoretically involve the frontal bone, midface, and mandible.
- In clinical practice, fractures in two of these three areas are often termed panfacial fractures.
- Diagnosis relies on physical examination, radiography, and computed tomography (CT).
Purpose of the Study:
- To outline diagnostic methods for panfacial bone fractures.
- To describe the surgical management of panfacial bone fractures, emphasizing fixation techniques and sequencing.
- To report on the outcomes of the described surgical approach.
Main Methods:
- Diagnosis through physical examination, conventional radiography, and CT scans.
- Surgical treatment predominantly involves open reduction and internal fixation (ORIF).
- Preferred surgical sequence: 'top to bottom' and 'outside to inside', starting with arch bar application, followed by frontal bone, midface, and mandibular fracture fixation.
Main Results:
- Most panfacial bone fractures necessitate ORIF.
- Maintaining facial width is a critical surgical consideration.
- The described surgical sequence and fixation methods achieve acceptable patient outcomes.
Conclusions:
- Conservative treatment is suitable for linear fractures only.
- ORIF is the standard for complex panfacial fractures.
- A systematic surgical approach focusing on facial width and sequential fixation leads to satisfactory results.
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