Utilizing Firm Segments in the Treatment and Reconstruction Strategy of the Facial Contour for Patients with...

Currently, there are two classic approaches to correcting and setting fractured facial bones globally, which are "Correction sequence from bottom to top-from inside to outside" and "Correction sequence from top to bottom-from outside to inside." No method achieves optimal results in all cases. Depending on each case, the surgeon applies the appropriate sequence of bone correction. Therefore, the application becomes mechanical when relying on one of the two treatment strategies. When patients are treated according to the third principle of correction based on the "firm segment," it becomes more flexible and effective. The "firm segment" here refers to the most stable area on the face, allowing the correction of fractures near cthe "firm segment" first, followed by those farther away.

Patients with pan-facial fractures, classified according to Follmar's classification, undergo Computed Tomography (CT) scans and Three Dimensional (3D) reconstruction to identify the "firm segment" on the 3D images. From there, the correct occlusion is determined, and the fractures are set according to the principle of setting fractures near the firm segment first, followed by those farther away from the firm segment.

48 patients with pan-facial fractures classified according to Follmar's classification have been identified with the firm segment on 3D images. There are 4 types of firm segments divided on the images, providing the basis for correcting the right occlusion and setting fractures, restoring the facial contour.

Correcting based on "Firm segment" is one of the strategies to effectively treat Pan facial fractures, this is an organized and flexible approach, setting fractures near the "firm segment" first and followed by those farther away. This strategy helps shorten the surgical time, ensure stability of the fractures, restore the anatomical shape of facial skeleton and function of the organs.