Midface Fractures II

Agrawal, Nikhil; Truong, Tuan; Louis, Mariam

doi:10.1055/s-0037-1601373

Cited by 21 publications

(24 citation statements)

References 14 publications

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“…Consistent with the literature, we found a male-to-female ratio of 3.1:1 in patients with panfacial fractures. [ 2 3 6 9 10 13 14 22 23 24 25 ] We found two or three fracture sites in most patients (a total of 77.4% of all patients with panfacial fracture); in a few patients, up to nine fracture sites had been identified and treated. The fracture frequency was higher than in the literature (3.13 vs.…”

Section: Discussionmentioning

confidence: 77%

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

Bicsák¹,

Abel²,

Wruck³

et al. 2021

Ann Maxillofac Surg

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Introduction: Panfacial fractures represent the most severe injuries to the face. The combination of these fractures determines the treatment strategy. This study aims to retrospectively review the data of adult patients treated for complex facial skull fractures in a hospital in Dortmund, Germany from 2015-2017. Materials and Methods: We extracted related patient data from the hospital electronic repository and reviewed the patient files and radiological images. The fractures were classified based on the AO-Classification. The statistical analysis was performed by descriptive statistical methods. The main goal was to determine the most common fracture combinations. Results: A total of 188 patients with panfacial fractures were identified (181 adults, 7 children and adolescents). The gender and age distribution corresponded to the international literature (male-to-female ratio: 3.1:1, most common injuries among young men). 2–9 fracture sites were identified per patient, resulting in a fracture frequency of 3.13 per patient. 69 different fracture combinations have been identified. The most common ones were combinations of lateral and central mid-face fractures, and combinations of nasal bone fractures with lateral midface fractures or nasal bone fractures combined with mandibular fractures. Between 1 and 13 osteosynthesis implants per patient were used for osteosynthesis; the most commonly used plates were 2.0 mm and 1.5 mm straight plates. The average inpatient stay was 3 days (standard deviation [SD] = 3.0 days), and the average operation time (incision to suture) was 39.5 min (SD = 53.5 min). Discussion: Panfacial fractures are the most complex maxillofacial injuries. The complication rate in this study (4.5%) is below the international data. The treatment of panfacial fractures requires designated centers with experienced teams and good interdisciplinary cooperation.

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Section: Discussionmentioning

confidence: 77%

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

Bicsák¹,

Abel²,

Wruck³

et al. 2021

Ann Maxillofac Surg

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“…Middle-level transverse fracture LeFort type II presents a direct mechanism of production through a frontal impact in the middle vault of the viscerocranium. Fracture lines begin in the middle third of the nasal opening through the nasal bones bilaterally, the ascending arch of the maxillary bone, the lacrimal bone, the ethmoid bone, the floor of the orbit till the spheno-maxillary junction, the anterior wall of the maxillary sinus, and the middle third of the pterygoid plate [14].…”

Section: Classification Of Midfacial Fractures According To Lefortmentioning

confidence: 99%

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

Vrînceanu¹,

Bănică²,

Dumitru³

2021

Trauma and Emergency Surgery - The Role of Damage Control Surgery

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Midfacial trauma is never an immediate therapeutic emergency excepting cases with nasal bleeding and risk of aspiration or requiring a permeable airway that will allow intubation when appropriate. The patient with polytraumas and midfacial fractures who needs ear, nose, and throat (ENT) or oral and maxillofacial (OMF) surgery should be reassessed at 24 and 48 hours to determine the optimal operating time. The surgical indication should be established according to esthetic and functional deficits. We consider that the optimal operative moment for the lesions of the midface is at 4-5 days after the trauma, under the conditions of a stable hemodynamic, respiratory, and afebrile patient. We propose the schematic presentation of the principles of diagnosis and treatment for midface trauma. We will discuss also some aspects of midfacial trauma during coronavirus disease-2019 (COVID-19) pandemic conditions. We must assume every patient with polytrauma as a COVID-19-positive patient. So, it is necessary to have a special circuit for a suspect COVID-19 polytrauma patient between emergency room (ER) department, operating room, and intensive care unit (ICU). All medical team must wear high-level personal protective equipment (PPE) during emergency treatment of a craniofacial trauma in the context of polytrauma until we get the result of RT-PCR testing.

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“…The bones of this zone have mainly a vertical type of structure of spongy trabeculae and the presence of four buttresses [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the anatomical structure, on the one hand, provides an intimate connection of the bones of the face middle area, on the other -is a factor determining the direction of the fracture. The nature of the damage, the shape and direction of the fracture are not accidental, but due to the mechanism of action of the impact force and depend not only on the magnitude and direction of the impact force, size and shape of the object, weapon, but also on properties related to bone architecture and distribution of force vectors acting on impact on specific bone elements [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Since buttresses and so-called places of weak resistance are located in relation to each other in different planes, it is natural that the effective force of impact to one of them will be directed perpendicularly, to another -parallel, and to the third --at an angle and, therefore, will cause quite diverse and numerous fractures of the middle zone of the face [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Results of using 3-D simulation methods in treatment of midfacial fractures

Grigorov

2021

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The article publishes the results of treatment of 27 patients with fractures of the face middle area, of which 14 used standard titanium mini-plates to reposition the fragments, and 13 – individual 3D simulated titanium mini-plates / grids. Before and after treatment, its effectiveness was assessed by the values of the displacements of bone fragments and the index of the visual-analog scale, which allows determining the functional and cosmetic effect of the surgery. It was found that the use of individual 3D simulated titanium mini-plates / grids allowed obtaining in 85 % of patients displacements not exceeding 3 mm. In 72 % of patients in whom standard titanium mini-plates were used, the displacement after surgery was 3.1–6 mm, which is significantly greater than in the group with individual modeling of structures. On the 7th day after surgery in the first group (treatment with standard mini-plates), the index on the visual-analog scale was 11 (7; 13), which was significantly (p=0.00147) less than before surgery. In the second group (treatment using individual 3D simulated titanium mini-plates / grids) the index on the visual analog scale was 4 (6; 8) points, which was significantly (Z=3.3; p=0.00098) less than before surgery. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. The obtained results testify to the greater efficiency of individual 3D modeled titanium mini-plates / grids in comparison with standard titanium mini-plates. The object of the research: fractures of the middle area of the face. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. Investigated problem: the comparative evaluation of the effectiveness of the middle area of the face fractures treatment using individual 3D simulated titanium mini-plates / grids and standard titanium mini-plates. The main scientific results: Optimizing the treatment of fractures of the face middle area will help to achieve good cosmetic and functional results. The area of practical use of the research results: Department of Surgical Dentistry and Maxillofacial Surgery. Innovative technological product: The proposed technique using individual 3D-simulated titanium miniplates will help to optimize the treatment of patients with traumatic fractures of the face middle area. Scope of the innovative technological product: Clinical practice.

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Midface Fractures II

Cited by 21 publications

References 14 publications

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

Results of using 3-D simulation methods in treatment of midfacial fractures

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