Maxillofacial Gunshot Injuries Research Articles

Maxillofacial gunshot injuries among civilians in south- western Nigeria

Maxillofacial gunshot injuries among civilians in south- western Nigeria

Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression–osteodistraction

We have treated 33 young men with medium to large (3–8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression–distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3–4.5 months.

Reconstruction and rehabilitation of short-range, high-velocity gunshot injury to the lower face: a case report

War injuries can range from the most minor to the devastating and life-threatening. Multidisciplinary care is required for successful management of survivors. In the acute phase, care may involve emergency surgeons, anaesthetists, neurosurgeons, ophthalmic surgeons, vascular surgeons and ENT specialists in addition to the oral and maxillofacial surgeon. Afterwards, definitive treatment of facial hard and soft tissue gunshot injuries depends ultimately on the abilities and skills of the oral and maxillofacial surgeon and his appreciation of such injuries. The timing and sequence of the surgical procedures used for reconstruction and rehabilitation of maxillofacial gunshot injuries are crucial to a successful outcome and aesthetic result. If incorrect, they may lead indefinitely to infection, graft rejection, wound dehiscence with consequent multiple revisional operations and complications which will prolong hospital stay, and increase treatment costs and morbidity in these patients. In this article, we describe the treatment protocol for reconstruction and rehabilitation of a typical case of devastating gunshot injury to the lower face and propose a staged sequence of surgical treatment based on an 8-year experience gained in treating war casualties during the Iraq-Iran war (1980-1988).

Management of missile wounds of the maxillofacial region during the 20th century

Rapid evacuation from the scene of injury, the Advanced Trauma Life Support (ATLS) protocol and advancements in medical and surgical practice afford high standards of care for maxillofacial gunshot wounds (GSWs). This series of nine case reports illustrates both the changes that have occurred and the similarities that remain in the management of these wounds since the First World War. It serves as a reminder of the problems that may be faced managing maxillofacial injuries both in a future conventional war and also increasingly in the civilian population.

Radiology of maxillofacial gunshot injuries

The relative advantages and disadvantages of conventional facial radiographic techniques, facial tomography, and carotid arteriography for gunshot injury cases are discussed. The conventional series of skull, facial, or cervical spine projections forms a base line upon which the more complex procedures may be added. Five cases illustrate the radiographic principles involved in the determination of gunshot fragment localization, bone fracture, soft-tissue swelling, and maxillary sinus involvement.