Abstract
The past two decades have witnessed significant advances in the repair of extensive craniofacial injuries. Rigid fixation techniques and the adaptation of craniofacial surgical approaches have made exposure and fixation of the entire anterior craniofacial skeleton possible. Given this capability, much attention has been focused on developing an organized plan of repair that optimizes restoration of pretraumatic facial form and function. Successful reconstruction can be achieved through a flexible approach that adheres to several key principles. First, comminuted subunits are individually reconstructed, then rigidly fixed to each other and finally connected to a region of stability via their associated buttresses. Second, reestablishment of occlusion and facial width is of paramount importance. Management of the naso-orbital-ethmoid region, the aesthetic core of the face, should be considered early in the sequencing of fractures. Finally, soft-tissue relationships must be reestablished after wide craniofacial exposure.
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