Controversies in Maxillofacial Trauma

Meara, Daniel J.; Jones, Lewis C.R.

doi:10.1016/j.coms.2017.06.002

Cited by 15 publications

(20 citation statements)

References 59 publications

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“…Nevertheless, it takes about 3 to 5 days to get the surgical splints in our practice, which is acceptable period for maxillary or mandibular fracture management. 3,29 At this time, patients start to have decreased swelling and are more clinically stable to undergo surgery. Second, there could be a steep learning curve between surgeons and biomedical engineers in term of design and fabrication of VSPSS.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Virtual Surgical Planning for Surgical Splint-Assisted Comminuted Maxillomandibular Fracture Reduction and/or Fixation

Kongsong

Sittitavornwong

2020

Craniomaxillofacial Trauma & Reconstruction

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Study Design: This article was a technical note. Objective: To demonstrate the utilization of virtual surgical planning for surgical splint (VSPSS) fabrication. The VSPSS was used as an intraoperative assisting and guiding tool for reduction and/or fixation of treatment of comminuted maxillomandibular fractures. Methods: The presented technical note showed the fabrication process that began with data acquisition and presurgical planning using virtual surgical planning (VSP). The VSPSS was designed and fabricated after the fractures were reduced digitally in VSP. In the operating room, the VSPSS was seated to guide reduction and/or allow satisfactory fixation in three different situations. Results: Postoperative radiographs showed an acceptable reduction of the fractures. All patients had stable and repeatable occlusion postoperatively. Conclusions: The VSPSS is a feasible tool for surgeons to assist in the comminuted maxillomandibular fracture management, decrease operating time, and improve fracture stability.

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Section: Discussionmentioning

confidence: 99%

Utilization of Virtual Surgical Planning for Surgical Splint-Assisted Comminuted Maxillomandibular Fracture Reduction and/or Fixation

Kongsong

Sittitavornwong

2020

Craniomaxillofacial Trauma & Reconstruction

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“…Durch eine MMF, sei es im Rahmen der konservativen Therapie für einen gewissen Zeitraum oder nur temporär im Rahmen der operativen Versorgung, kann über eine regelhafte Okklusion die anatomisch korrekte Reposition der Frakturenden erreicht werden. Die konservative Frakturbehandlung, auch wenn seit Jahrhunderten so durchgeführt [2] folgt in Analogie zur offenen, chirurgischen Frakturbehandlung den Prinzipien der Reposition und Retention [3] und ist heutzutage weitestgehend in den Hintergrund getreten und nur speziellen Indikationen vorbehalten [4].…”

Section: Die Frakturbehandlung In Der Mund- Kiefer-und Gesichtschiruunclassified

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen in der Mund-, Kiefer- und Gesichtschirurgie

Koerdt¹,

Sabatakakis²,

Heiland³

et al. 2019

OP-JOURNAL

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ZusammenfassungDie osteosynthetische Versorgung mit Miniplatten oder Rekonstruktionsplatten stellt in der Mund-, Kiefer- und Gesichtschirurgie den operativen Standard in Versorgung von Gesichtsschädelfrakturen und bei der Fixation autologen Knochentransplantate dar. Intra- und extraorale Zugangswege zum knöchernen Gesichtsschädel sowie die Belastung durch Kaukräfte, Lagebeziehung zur Mundhöhle und Nasennebenhöhlensystem sowie die Okklusion können zu einem Misserfolg der Osteosynthese beitragen. Zu den häufigsten Komplikationen gehören Materiallockerung, Materialbruch, sekundäre Fragmentdislokation und Infektion.

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“…1 There is a paucity of data to guide management of these injuries, particularly pertaining to the nature and duration of antibiotic prophylaxis. [2][3][4] It is probably not appropriate to extrapolate care for these lesions from the management of open long-bone fractures 5 or facial fractures, 6,7 for which blood supply and microbiology differ and meningitis is not a risk, or even from experience with fractures of the basilar skull, 8 where only exposure to nasopharyngeal flora must be considered.Open skull fractures represent a wide spectrum of in-jury ranging from linear, nondepressed fractures with an adjacent puncture wound of the scalp to large, depressed lesions with overlying soft-tissue loss or significant bacterial contamination. Recognizing that these diverse injuries must be cared for on a case-by-case basis, we sought to evaluate the management of a large population of patients with open calvarial skull fractures managed at multiple pediatric trauma centers to define contemporary care for these injuries and better define appropriate care.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Contemporary management of pediatric open skull fractures: a multicenter pediatric trauma center study

McFall¹,

Beier

Hayward

et al. 2021

Journal of Neurosurgery: Pediatrics

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OBJECTIVE The authors sought to evaluate the contemporary management of pediatric open skull fractures and assess the impact of variations in antibiotic and operative management on the incidence of infectious complications. METHODS The records of children who presented from 2009 to 2017 to 6 pediatric trauma centers with an open calvarial skull fracture were reviewed. Data collected included mechanism and anatomical site of injury; presence and depth of fracture depression; antibiotic choice, route, and duration; operative management; and infectious complications. RESULTS Of the fractures among the 138 patients included in the study, 48.6% were frontal and 80.4% were depressed; 58.7% of patients underwent fragment elevation. The average duration of intravenous antibiotics was 4.6 (range 0–21) days. Only 53 patients (38.4%) received a single intravenous antibiotic for fewer than 4 days. and 56 (40.6%) received oral antibiotics for an average of 7.3 (range 1–20) days. Wounds were managed exclusively in the emergency department in 28.3% of patients. Two children had infectious complications, including a late-presenting hardware infection and a superficial wound infection. There were no cases of meningitis or intracranial abscess. Neither antibiotic spectrum or duration nor bedside irrigation was associated with the development of infection. CONCLUSIONS The incidence of infectious complications in this population of children with open skull fractures was low and was not associated with the antibiotic strategy or site of wound care. Most minimally contaminated open skull fractures are probably best managed with a short duration of a single antibiotic, and emergency department closure is appropriate unless there is significant contamination or fragment elevation is necessary.

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Controversies in Maxillofacial Trauma

Cited by 15 publications

References 59 publications

Utilization of Virtual Surgical Planning for Surgical Splint-Assisted Comminuted Maxillomandibular Fracture Reduction and/or Fixation

Utilization of Virtual Surgical Planning for Surgical Splint-Assisted Comminuted Maxillomandibular Fracture Reduction and/or Fixation

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen in der Mund-, Kiefer- und Gesichtschirurgie

Contemporary management of pediatric open skull fractures: a multicenter pediatric trauma center study

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