[Principles of treating facial fractures]

The therapy of facial fractures is aimed at an early definitive treatment. Exact repositioning of the fragments is first achieved by setting the right occlusion. Intermaxillary fixation is then performed by interdental arch bars reenforced with acrylic material and intermaxillary rubber bands or wire. The middle third of the face is mainly subjected to static forces. Fractures in this area are therefore set and fixated with interosseous wire ligatures. Craneofacial suspension is carried out by means of a craneofixateur extern. Fractures of the mandible are treated differently. In order to counteract the strong dynamic forces internal fixation is necessary using compression plates in combination with tension bands. Another modality of treatment by a specially designed plate with excentric gliding holes renders the tension bands superfluous since it is capable of applying compression forces also at the dental area. In fractures with osseous defects long plates are used which stabilize the mandibular arch. If the articular prominence is missing these plates may be applied with a capitular end in order to reconstruct the articulation.