Facial Fractures

2020 ◽  
Author(s):  
Branko Bojovic ◽  
Martin Buta
Keyword(s):  
Patient Outcomes ◽  
Surgical Planning ◽  
Intraoperative Imaging ◽  
Facial Trauma ◽  
Facial Fractures ◽  
The Face ◽  
Fixation Techniques ◽  
Resolution Imaging ◽  
Craniofacial Fractures ◽  
Refined Classification

The understanding and management of craniofacial fractures have evolved through remarkable innovations in high-resolution imaging, surgical and fixation techniques, endoscopy, biomaterials and implants, bone grafting, new and refined classification frameworks, and algorithms for intervention. The concept of facial buttresses first described forty years ago now serves as a guide to reconstruction of the underlying skeleton to re-establish the height, width, and projection of the face. With the advent of 3D computed tomography and intraoperative imaging, surgeons have expanded the armamentarium for surgical planning and navigation, especially beneficial for accurate repair in complex cases. All of these advances have improved patient outcomes and raised expectations for functionally and aesthetically acceptable results. A brief overview of the assessment and management of facial fractures is presented. This review contains 1 figure, 4 tables, and 43 references. Key words: facial fracture, facial trauma, plastic surgery, orbital, maxillofacial, injury, Le Fort, malocclusion, skeletal buttress

Three Dimensional CT Reconstruction for the Evaluation and Surgical Planning of Facial Fractures

1986 ◽  
Vol 95 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Peter J. Koltai ◽  
Gary W. Wood
Keyword(s):  
Surgical Planning ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Data Systems ◽  
Ct Reconstruction ◽  
Facial Fractures ◽  
Facial Skeleton ◽  
The Face ◽  
Spatial Imagination ◽  
The Relationship

Despite advances in radiology—including CT scanning—the three-dimensional (3D) nature of facial fractures must still be inferred by the spatial imagination of the physician. A computer system (Insight Phoenix Data Systems, Inc., Albany, N.Y.) uses CT studies as substrate for 3D reconstructions. We have used the insight computer for the evaluation and surgical planning of facial fractures of 16 patients with complex injuries. We present five illustrative cases, directly photographed from the computer monitor. Images can also be manipulated in real time by rotating or planar sectioning (functions best appreciated on video). The ability to cybernetically extract the facial skeleton from living subjects provides precise anatomic data previously unobtainable. The images are valuable for an accurate assessment of the relationship between the injured and uninjured sections of the face. We conclude that 3D reconstruction is an important advance in the treatment of facial fractures.

scholarly journals Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil

2021 ◽  
Vol 48 ◽  
Author(s):  
VINÍCIUS AZEREDO MULLER ◽  
GUSTAVO KRUMMENAUER BRUKSCH ◽  
GIORDANO SANTANA SÓRIA ◽  
KAREN DA ROSA GALLAS ◽  
FLÁVIO RENATO REIS DE-MOURA ◽  
...  
Keyword(s):  
Medical Records ◽  
Recovery Time ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Prevention Strategies ◽  
Factors Associated ◽  
Elapsed Time ◽  
The Face ◽  
Cox Analysis

ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

scholarly journals ANGKA KEJADIAN PENDERITA FRAKTUR TULANG FASIAL DI SMF BEDAH BLU RSU PROF. R.D. KANDOU PERIODE JANUARI 2012 – DESEMBER 2012

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Christo Kairupan ◽  
A. Monoarfa ◽  
J. Ngantung
Keyword(s):  
Bone Fracture ◽  
Medical Records ◽  
Traffic Accidents ◽  
Nasal Bone ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Facial Bones ◽  
Mandibular Bone ◽  
Number Of Patients ◽  
The Face

Abstract: Facial Trauma, also known as maxillofacial trauma, is a forced to the face. Trauma maxillofacial occurred about 6% of all trauma. Trauma Facial causing fractures facial that happen a lot. Facial fractures occur because of trauma load that is greater than facial bones resistance. Facial fractures are divided into several parts, the nasal bone fracture, fracture zygoma and zygoma arch, maxilla fractures, orbital fractures and fractures of the mandible. With the increase of people’s mobilization and a growing level of transportation, causing accident that led to increased facial trauma. The research objective was to determine the incidence of facial fractures in patients SMF BLU Surgical Hospital Prof. R. D. Kandou the period January 2012 to December 2012. Research method: Retrospective descriptive study of the medical records in SMF BLU Surgical Hospital Prof. Dr. R.D. Kandou Manado from January 2012 to December 2012 is used in this paper. Result: Number of patients with facial fractures who were treated at the Surgical SMF period January 2012-December 2012 as many as 156 cases (5.60%) of the total of 2786 treated facial trauma. Most facial fractures age are 20-29 years that is 78 (50.00%), men are more than women that 132 cases (84.62%); most private sector employees work as many as 40 cases (25.64%), the highest in the District Malalayang by 49 cases (31.41%), the most common cause of traffic accidents as many as 82 cases (52.56%), as well as the location of the mandibular bone fracture is the most, 72 cases (39.77%). Conclusion: Trauma face causing facial fractures that went on SMF Surgical Hospital Prof R. D. Kandou still quite high, so it is necessary to continually educate people to avoid the possibility of injury in day-to-day activities. Keywords: facial trauma, facial fractures, facial bones.   Abstrak: Trauma fasial disebut juga trauma maksilofacial adalah trauma akibat ruda paksa terhadap wajah. Trauma maksilofacial terjadi sekitar 6% dari seluruh trauma. Trauma fasial menyebabkan fraktur fasial yang banyak terjadi. Fraktur tulang fasial terjadi karena beban trauma yang lebih besar dari tahanan tulang fasial. Fraktur fasial dibagi menjadi beberapa bagian, yaitu fraktur tulang hidung, fraktur zigoma dan arkus zigoma, fraktur maksila, fraktur orbita dan fraktur mandibula. Dengan peningkatan mobilisasi penduduk serta tingkat transportasi yang berkembang, menyebabkan insiden kecelakaan yang menyebabkan trauma fasial meningkat. Tujuan penelitian adalah Untuk mengetahui angka kejadian penderita fraktur tulang fasial di SMF Bedah BLU RSU Prof. R. D. Kandou periode Januari 2012 sampai Desember 2012. Metode penelitian: metode retrospektif deskriptif melalui penelitian data rekam medik di SMF Bedah BLU RSU Prof. Dr. R.D. Kandou Manado periode Januari 2012 sampai Desember 2012. Hasil penelitian: Jumlah penderita fraktur fasial yang dirawat di SMF Bedah periode Januari 2012-Desember 2012 sebanyak 156 kasus (5,60%) dari total 2786 trauma fasial yang dirawat. Usia terbanyak fraktur fasial 20-29 tahun yaitu 78 (50,00%); pria lebih banyak wanita yaitu 132 kasus (84,62%); dari pekerjaan paling banyak pegawai swasta sebanyak 40 kasus (25,64%); terbanyak di Kecamatan Malalayang sebesar 49 kasus (31,41 %); penyebab terbanyak akibat kecelakaan lalulintas yaitu sebanyak 82 kasus (52,56 %); serta lokasi fraktur terbanyak adalah tulang mandibula sebanyak 72 kasus (39,77 %). Simpulan: Trauma wajah yang menyebabkan fraktur fasial yang masuk di SMF bedah RSU Prof R. D. Kandou masih cukup tinggi, sehingga diperlukan edukasi terus menerus kepada masyarakat agar menghindari kemungkinan terjadinya trauma, dalam kegiatan sehari-hari. Kata kunci: trauma fasial, fraktur fasial, tulang-tulang wajah.

Rehabilitation of A Patient with Iatrogenesis After Facial Trauma - Case Report

2021 ◽  
Author(s):  
Keith Murieli Ferreira de Magalhães
Keyword(s):  
Surgical Planning ◽  
Attempted Suicide ◽  
Facial Trauma ◽  
Oral Rehabilitation ◽  
Surgical Guide ◽  
The Face ◽  
Trauma Case ◽  
Implant Dentistry ◽  
High Level ◽  
Inexperienced Surgeon

The objective of this study is to report a clinical case of a female patient, melanoderma, 18 years old, referred to the FOA-UNESP surgery and traumatology team in 2013, reporting being a victim of a high-level fall in the attempted suicide. Clinical examination revealed loss of teeth 33, 32, 31, 41, 42, 43 and 44 and CT scan of the face revealed NOE, Lefort I and II and Lanelong fractures. The patient underwent a surgical procedure to reduce and fix fractures. The case was followed up after hospital discharge. A mandible CT was requested to install dental implants. Surgical planning was performed to install implants and make a surgical guide. 4 implants were installed in the region of teeth 32, 31, 41, 42, 43. Two years after the implant was installed, the patient returned to the institution reporting pain in tooth 45. The patient was referred by the screening sector to the endodontic team, which requested a new CT examination of the mandible, noting that the implants installed in the regions of teeth 33 and 44 had reached teeth 34 and 45, indicating the extraction of these teeth and removal of 2 implants. Surgical planning was performed and the extraction and removal surgery of the implants performed. After waiting for the healing period, the patient was referred to the dental prosthesis team and it was defined that reverse planning would be carried out to install the new implants and oral rehabilitation using a supported implant prosthesis. Thus, the impressions left by the case allow us to conclude that the use of a surgical guide, without prosthetic planning, provides the inexperienced surgeon with false security for the procedure, with reverse planning and professional experience essential for implant dentistry.

scholarly journals Risk Management of Neuroanesthesia in Traumatic Brain Injury with Multiple Facial Fractures and Subcutaneous Emphysema in terms of Ethical and Medicolegal Aspects

2020 ◽  
Vol 2 (3) ◽  
pp. 609-614
Author(s):  
Kulsum ◽  
Taufik Suryadi
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Management ◽  
Brain Injury ◽  
Patient Outcomes ◽  
Subcutaneous Emphysema ◽  
Clinical Ethics ◽  
Medical Decision ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Water Seal

Every medical practice including neuroanesthesia always contains risks, so risk management is needed. Neuroanesthesia in cases of traumatic brain injury (TBI) with multiple facial fractures and subcutaneous emphysema is one of the risky prosedure that must be done very carefully and professionally. A case reported by a man, 53 years old, weight 80 kg, decreased consciousness due to head trauma and facial trauma and the presence of widespread subcutaneous emphysema. Performed risk management in the form of airway management, installation of water seal drainage and perioperative neuroanesthesia aimed at reducing intracranial pressure and maintaining adequate cerebral perfusion pressure. Medical decision making in this case does not only give attention to medical aspects but also must give attention to aspects of clinical ethics and medico-legal. Criteria for TBI patients with multiple facial fractures and subcutaneous emphysema for neuroanesthesia based on ethical and medicolegal considerations can be carried out based on clinical ethics theory and neuroanesthesia risk management so as to produce good patient outcomes.

THE ROLE OF MULTI DETECTOR COMPUTERIZED TOMOGRAPHY (MDCT) IN EVALUATION OF MAXILLOFACIAL FRACTURES.

2021 ◽  
pp. 55-58
Author(s):  
P. Mamatha ◽  
V. Venkatarathnam ◽  
R. Ramesh Kumar ◽  
Hameed Arafath
Keyword(s):  
Computerized Tomography ◽  
Surgical Planning ◽  
Nasal Bone ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Maxillofacial Region ◽  
Number Of Patients ◽  
Maxillofacial Fractures ◽  
Classi Cation

Objective: The purpose of our study was to assess the role of Multidetector Computerized tomography in the evaluation of maxillofacial fractures and to describe the frequency and types of fractures that underwent CT scans. Subjects And Methods: The study included 50 patients suspected of facial trauma referred from the emergency unit from PESIMSR ,Kuppam. All patients were subjected to non contrast MDCT in axial cuts and images are transferred to workstation then coronal and sagittal reconstruction obtained. Results: There were 37 male and 13 female patients. The maximum number of patients fall into 21-40 years followed by 41 to 60 years .50 patients had total 170 fractures. It was found that the maxillary sinus is the most common to be fractured (found in 24 cases) followed by nasal bone (18) , zygomatic arch (17), mandible (13) ,greater wing of sphenoid (9), sphenoid sinus (8), frontal sinus (7) ,pterygoid plates (7), bony nasal septum (6) ,ethmoid sinus (3).Among complex facial fractures orbital fractures are the most frequent (found in 47 cases), followed by zygomatico-maxillary junction fractures (4) ,Tripod fractures( 4) , and Naso-orbito-ethmoid region fractures (3). Conclusion: Maxillofacial trauma is one of the most common emergency requiring accurate and early diagnosis. MDCT is useful diagnostic tool for the identication and classication of maxillofacial region fractures and aiding in surgical planning.

Factors Associated With Violence Against Women and Facial Trauma of a Representative Sample of the Brazilian Population: Results of a Retrospective Study

2020 ◽  
pp. 194338752094933
Author(s):  
Gabriela Mayrink ◽  
Stella Araújo ◽  
Laisa Kindely ◽  
Renato Marano ◽  
Aguimar Bourguinon de Mattos Filho ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Health Care Professionals ◽  
Mixed Race ◽  
Signs And Symptoms ◽  
Epidemiological Survey ◽  
Facial Trauma ◽  
Health It ◽  
Tertiary Referral Hospital ◽  
The Face ◽  
Important Marker

Study Design: Violence against women is a challenge in public health. It involves women of all ages, socioeconomic statuses, cultures, and religions. Objective: The objective of this study was to perform an epidemiological survey of facial trauma among women who experienced physical aggression by an intimate partner. Methods: Electronic medical records from a public tertiary referral hospital for trauma in the Brazilian state of Espírito Santo were analyzed between 2013 and 2018. Results: Patients were most commonly between 20 and 29 years of age (33.9%), and 50% of the patients were of mixed race. When separated by days of the week, facial trauma was most commonly inflicted on Sundays (24.2%) and on Saturdays (22.6%). Of the 62 women included in the study, 47 had facial fractures, and 7 had more than 1 concomitant fracture. Forty of the total fractures (72.7%) were on the middle and upper thirds of the face, while 15 fractures (27.3%) were on the lower third of the face. The most commonly observed signs and symptoms of these injuries were edema (56.5%), periorbital ecchymosis (35.5%), deviated nasal dorsum (22.6%), and hematoma (16.1%). Conclusions: Facial trauma may be considered an important marker of attempted femicide. Health care professionals must be aware of and attentive to this correlation, since many cases of attempted femicide go unnoticed or are attributed to another etiology.

Facial Surface Anthropometric Features and Measurements With an Emphasis on Rhinoplasty

2021 ◽  
Author(s):  
M Mazhar Celikoyar ◽  
Michael F Perez ◽  
M Ilhan Akbas ◽  
Oguzhan Topsakal
Keyword(s):  
Surgical Planning ◽  
Medical Literature ◽  
Facial Features ◽  
Post Surgery ◽  
Anthropometric Features ◽  
The Face ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Objective Outcomes ◽  
A Current

Abstract Background Facial features and measurements are utilized to analyze patients’ faces for various reasons, including surgical planning, scientific communications, patient-surgeon communications, and post-surgery evaluations. Objectives There are numerous descriptions regarding these features and measurements scattered throughout the literature and we did not encounter a current compilation of these parameters in the medical literature. Methods A narrative literature review of the published medical literature for facial measurements used for facial analysis in rhinoplasty was done through the electronic databases MEDLINE/PubMed and Google Scholar, along with a citation search. Results A total of 61 facial features were identified. 45 points (25 bilateral, 20 unilateral), five lines (three bilateral, two unilateral), eight planes, and three areas. A total of 122 measurements were identified: 48 distances (6 bilateral, 42 unilateral), 57 angles (13 bilateral, 44 unilateral), and 17 ratios. Supplemental Figures were created to depict all features and measurements using either a frontal, lateral or basal view of the face. Conclusions This paper provides the most comprehensive and current compilation of facial measurements to date. We believe this compilation will guide further developments (methodologies and software tools) for analyzing nasal structures and assessing the objective outcomes of facial surgeries, in particular rhinoplasty. Moreover, it will improve the communication as a reference for facial measurements of facial surface anthropometry, in particular rhinoplasty.

Injury Patterns in Pediatric Facial Fractures Unique to an Urban Environment

2021 ◽  
Author(s):  
Anthony P. Sclafani ◽  
Matthew Scott Sclafani ◽  
Sallie Long ◽  
Tasher Losenegger ◽  
Daniel Spielman ◽  
...  
Keyword(s):  
Urban Environment ◽  
Older Patients ◽  
High Energy ◽  
Urban Setting ◽  
Cranial Bone ◽  
Csf Leak ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Associated Injuries ◽  
Facial Fractures

AbstractThis study aimed to define better the clinical presentation, fracture patterns, and features predictive of associated injuries and need for surgery in pediatric facial trauma patients in an urban setting. Charts of patients 18 years or younger with International Classification of Disease 9th and 10th revision (ICD-9/ICD-10) codes specific for facial fractures (excluding isolated nasal fractures) at NY-Presbyterian/Weill Cornell Medical Center between 2008 and 2017 were retrospectively reviewed. Of 204 patients, most were referred to the emergency department by a physician's office or self-presented. Children (age 0–6 years) were most likely to have been injured by falls, while more patients 7 to 12 years and 13 to 18 years were injured during sporting activities (p < 0.0001). Roughly half (50.5%) of the patients had a single fracture, and the likelihood of surgery increased with greater numbers of fractures. Older patients with either orbital or mandibular fractures were more likely to undergo surgery than younger ones (p = 0.0048 and p = 0.0053, respectively). Cranial bone fractures, CSF leaks, and intracranial injuries were more common in younger patients (p < 0.0001) than older patients and were more likely after high energy injuries; however, 16.2% of patients sustaining low energy injuries also sustained cranial bone, CSF leak, or intracranial injury. In an urban environment, significant pediatric facial fractures and associated injuries may occur after nonclassic low kinetic energy traumatic events. The age of the patient impacts both the injuries sustained and the treatment rendered. It is essential to maintain a high index of suspicion for associated injuries in all pediatric facial trauma patients.

scholarly journals Epidemiology of Maxillo-Facial Trauma During COVID-19 Lockdown: Reports From the Hub Trauma Center in Milan

2020 ◽  
pp. 194338752098311
Author(s):  
Gabriele Canzi ◽  
Elena De Ponti ◽  
Federica Corradi ◽  
Roberto Bini ◽  
Giorgio Novelli ◽  
...  
Keyword(s):  
Interpersonal Violence ◽  
Trauma Center ◽  
Major Trauma ◽  
Suicide Attempts ◽  
Linear Trend ◽  
Trauma Team ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Epidemiological Changes ◽  
Systemic Symptoms

Study Design Retrospective study. Objective: Following SARS-CoV-2 pandemic break-out a lockdown period for the population and a reorganization of the Health System were needed. Hub-function Centers for time-dependent diseases were identified and Niguarda Hospital (Milan) was selected as main Regional Trauma Center. The purpose of our study is to report the experience of Niguarda Maxillofacial Trauma Team during this period, pointing out epidemiological changes in the presentation of trauma in comparison to the previous 3 years. Methods: Two hundred and sixteen patients were admitted to the Emergency Department from 8th March 2020 to 8th May 2020. One hundred and eighty-one had a diagnosis of Major Trauma and 36 had also facial fractures; 35 patients had isolated facial fractures. Data were compared to the activity during the same period in 2017-2019 and statistical analysis was carried out concerning demographic and clinical characteristics, trauma dynamics and positivity to COVID-19. Results: Cumulative curves of patients admitted because of Major Trauma describe a superimposable linear trend in years 2017-2019, while 2020 shows an increase from April 16th. Average age and number of more severe patients were higher than previous years. Epidemiological changes concerned road accidents, accidents involving pedestrians and cyclists, interpersonal violence, suicide attempts and domestic accidents. The incidence of facial fractures was confirmed through years and, according to its measured severity, 75% of patients required management. COVID-19 positivity without systemic symptoms didn’t influence the type of treatment. Conclusion: The COVID-19 lockdown offers a unique opportunity to study the reversal epidemiological effects on trauma.

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