Panfacial Fractures Management.

Abstract

Panfacial fracture represent a challenge for maxillofacial surgeons due to paucity of useful landmark and stable bone that can be used for fixation. Nowadays, with the availability of rigid and semi rigid fixations, understanding of the importance of the facial buttresses, bone grafting, and early intervention, the functional and cosmetic outcomes showed a significant improvement. Many treatment sequences exist in the literature including top to bottom, bottom to top, lateral to medial, and medial to lateral approach. To evaluate the outcome of "bottom to top, lateral to medial" sequence that we used in the management of panfacial fractures in term of function and cosmesis. This study included 73 patients with panfacial fractures admitted to the Maxillofacial and Plastic Surgery Department, Alexandria University. Most of the patients (n = 52, 71.23%) were aged between 21 and 40 years old. 83.56% (n = 61) of patients were male. Road traffic accidents was the most common cause of trauma (n = 57). The most common site involved in panfacial fracture was the middle and lower third (58%). The common complication observed was malocclusion (n = 6). Of these, 5 patients had minor malocclusion that was corrected orthodontically and only one patient required surgical intervention. The "bottom to top, lateral to medial' sequence for reduction and fixation of panfacial fractures is reliable with satisfactory results in term of function and cosmesis.