Management of severe maxillo-facial injuries

Maxillo-facial injuries have increased in incidence in Singapore due mainly to road traffic accidents. Approximately 450 cases are seen annually in the Singapore General Hospital. A review of 50 consecutive cases of severe maxillo-facial injuries seen in the Department of Plastic Surgery showed that the majority were Lefort II type fractures (64%) followed by Lefort I fractures (14%) and Lefort III fractures (8%). There were seven cases which had a combination of multiple facial fractures. The significant associated injuries occurred in the limbs (32%), the head (30%) and in the chest (8%). The emergency management of maxillo-facial trauma is discussed in some detail and some of the problems in the treatment of severe or multiple facial fractures are also highlighted in this paper.