Maxillary involvement in central craniofacial fractures with associated head injuries

From January 1983 through December 1990, we treated 703 patients with central craniofacial fractures. Among them 177 had maxillary fractures, with or without frontonasoethmoidal involvement. Of the 177, 151 patients were diagnosed in the acute stage. Using the Glasgow Coma Scale, these 151 patients were divided into three groups: group I (GCS score 13-15), 100 patients; group II (GCS score 9-12), 33 patients; group III (GCS score 3-8), 18 patients. The patterns of facial fractures were analyzed and surgically corrected after the following average postadmission lags: group I, 7.1 days; group II, 11.5 days; group III, 13.3 days. The average hospital stay for each group was: group I, 15.6 days; group II, 19.5 days; and group III, 27.2 days. The mean follow-up period was 12 months. The physiologic, functional and esthetic outcomes were assessed. Regardless of initial head injury severity, the outcomes in each group showed almost no statistically significant differences, and unnecessary extended hospital stays may be avoided by early surgical management.