Developments and controversies in maxillofacial trauma: Repair of facial injuries

Abstract

Craniofacial trauma remains a common health problem throughout many areas of the UK. Although the ‘combination of alcohol and testosterone’ is often regarded as a major aetiological factor, a significant number of injuries are not related to either. Motor vehicle collisions and equine-related sports injuries in particular can result in devastating injuries to the skull and face and are frequently seen.Over the last few decades, management has moved away from closed methods to open exposure, anatomical reduction and internal ‘rigid’ fixation of facial fractures, with significant improvements in outcomes. Nevertheless, current management of ‘high energy’ or complex fractures can still result in residual functional disability and cosmetic deformity.Today’s challenge is to restore patients back to their pre-injury form and function, consistently, but this is not always possible. Greater understanding and a number of developments have significantly improved outcomes, although controversy still exists in some areas. Some of these will be discussed.