Management of Midfacial Fractures

Abstract

The management of midfacial fractures includes the treatment of facial fractures, dentoalveolar trauma, and soft-tissue injuries, as well as associated injuries, mainly of the head and neck [1]. The management of fractures of the maxillofacial complex remains a challenge for the oral maxillofacial surgeon, demanding both skill and expertise [2]. The success of treatment and implementation of preventive measures are more specifically dependent on epidemiologic assessments [3].Midfacial fractures can occur in isolation or in combination with other serious injuries, including mandibular, ophthalmologic, cranial, spinal, thoracic, and abdominal trauma, as well as upper and lower orthopedic injuries [4].The epidemiology of facial fractures varies in type, severity, and cause depending on the population studied. Differences among populations in the causes of maxillofacial fractures may be the result of differences in risk and cultural factors among countries, but are more likely to be influenced by the severity of injury [1,5]. The causes of maxillofacial fractures have changed over the past three decades, and they continue to do so. The main causes worldwide are traffic accidents, assaults, falls, sport-related injuries, and warfare [6-8]. Many articles pertaining to the incidence and causes of maxillofacial injuries have been published [1,4,7-10]. In 2003, Motamedi [7] reported the distribution of facial fractures as 72.9% mandibular, 13.9% maxillary, 13.5% zygomatic, 24.0% zygomatico-orbital, 2.1% cranial, 2.1% nasal, and 1.6% frontal injuries [Figure 1].