Emergency Management Patient with Multiple Mid-Lower Face Fracture and Tissue Avulsion of 1/3 Mid Face : A Case Report

Abstract

Introduction : Facial trauma can be defined as bone and or soft tissue damage in the face region. Severe facial trauma might cause life threatening and permanent damage such as vision loss, unable to speak, swallows and chews because there are many bones, blood vessels, nerves, muscles and sensory organs at the face region. The facial damage could be a facial bone fracture with severe avulsion of facial tissue so two-dimensional and three-dimensional measurement of the wound is taken to assess the size of tissue to be covered. The aim of this case report was to give an explanation regarding the emergency management patient with multiple mid-lower face fracture and tissue avulsion of 1/3 mid face. Case Report : A 46 years old male traffic accident patient came to Emergency Department Hasan Sadikin General Hospital with facial fracture and had a severe avulsion of facial tissue. He also had an active bleeding from his face and based on immediate examination the airway was not clear. The patient has been diagnosed with Le Fort I, right orbital rim inferior aspect, nasal, right zygoma and parasymphisis of mandible bone fracture and Tissue loss at upper lip, nasolabial, left nose, left buccal and Multiple lacerated wound at facial region. He was treated with tracheostomy to clear the airway continued with open reduction internal fixation at right orbital rim inferior aspect, nasal, right zygoma, bilateral maxilla bone and parasymphisis of mandible bone with wound closing using rotational and sliding loco regional flap technique. Conclusion : Emergency treatment on multiple facial fracture with severe avulsion of facial tissue must be done to prevent life threatening condition, permanent damage and also to support the secondary reconstruction. Keywords : Severe avulsion of facial tissue, Mid lower face fracture, Open reduction internal fixation, Rotational flap, Sliding loco regional flap