[Late sequelae of lateral and central mid-facial fractures after osteosynthesis with miniplates]

Despite significant progress in the therapy of craniofacial injuries permanent consequences of the trauma are still likely to occur. It has been possible to follow-up 105 (65.2%) of the 161 patients who were treated for lateral and central midfacial fractures in our department between 1989 and 1991. Pathological findings on follow-up were found in 48.6% of our patients. Most frequent were persistent disturbances of the sensitivity in the area of the second branch of the trigeminal nerve (32.4%). Patients who were operated within the first week after trauma did have significantly less sensory disturbances than patients who underwent surgery later. 7.6% of our patients had permanent double vision (4.8% in their primary vision field). After subciliary incision 3% had an ectropium which was not found after transconjunctival incision. There was no significant difference in the cosmetic outcome of the two approaches. In one patient who received silicone for restoration of the orbital floor the plate did migrate. Other materials that were used for orbital floor reconstruction did not cause problems. Based on the post-operative results improvements for the therapeutic regimen are discussed.