Pilot Study: Facial Trauma Reconstruction Outcomes: Systematic Review and Meta-analysis

Facial trauma reconstruction involves a range of surgical approaches aimed at restoring function and aesthetics following injury. Understanding the prevalence of complications and treatment outcomes is crucial for enhancing patient care, even as surgical techniques continue to advance. We aimed to evaluate the efficacy, safety, and outcomes of various surgical interventions for facial trauma reconstruction.

PubMed, Cochrane Library, and Google Scholar were searched through December 1, 2024, for studies reporting outcomes after surgical facial trauma reconstruction in adults. Quantitative meta-analysis was restricted to orbital fracture studies reporting diplopia and/or enophthalmos, using a random-effects model. Other outcomes were synthesized narratively due to clinical heterogeneity.

A total of 1218 records were identified; 9 studies met the inclusion criteria for the systematic review, and 7 contributed data to the orbital outcomes meta-analysis. The pooled prevalence of diplopia was 0.16 (95% confidence interval, 0.00-0.33; I ² = 80%), whereas enophthalmos had a prevalence of 0.15 (95% confidence interval, 0.05-0.26; I ² = 0%). Complications reported in nonorbital facial fractures, including infection, nonunion, and wound dehiscence, demonstrated wide variability across studies and were summarized narratively due to clinical and anatomical heterogeneity. Additional complications reported by individual studies included malunion, gross malocclusion, and nerve paresthesia. Overall, complication reporting varied substantially across nonorbital injuries, supporting anatomy-specific interpretation.

Orbital fracture reconstruction demonstrated descriptively low pooled prevalence estimates for diplopia and enophthalmos, although heterogeneity was substantial for diplopia and limits inferential interpretation.