Panfacial Fractures

Curtis, William J. R.; Horswell, Bruce B.

doi:10.1016/j.coms.2013.07.010

Cited by 46 publications

(26 citation statements)

References 20 publications

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“…Panfacial fractures are usually caused by high-energy injuries (e.g., motor vehicle or gunshot injuries) [ 7 ]. Panfacial fractures account for 4%–10% of all facial fractures.…”

Section: Epidemiology Of Panfacial Bone Fracturementioning

confidence: 99%

“…Numerous studies have compared combinations of these reduction sequences. However, the efficacy of inside-out or outside-in sequences have not been assessed independently of bottom-to-top or top-to-bottom sequences [ 4 5 6 7 9 ]. The “bottom-to-top and outside-in” approach is the most widely used method in the panfacial bone reduction [ 2 4 5 7 9 ].…”

Section: Various Sequences Of Panfacial Bone Reductionmentioning

confidence: 99%

“…However, the efficacy of inside-out or outside-in sequences have not been assessed independently of bottom-to-top or top-to-bottom sequences [ 4 5 6 7 9 ]. The “bottom-to-top and outside-in” approach is the most widely used method in the panfacial bone reduction [ 2 4 5 7 9 ]. Gruss and Phillips [ 11 ] advised starting panfacial reconstructions with reduction of the zygomatic arch and malar projection to establish the outer facial frame and to provide upper facial width and projection before NEO, maxillary, and mandibular reconstruction ( Fig.…”

Section: Various Sequences Of Panfacial Bone Reductionmentioning

confidence: 99%

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Panfacial Bone Fracture and Medial to Lateral Approach

Kim

Choi

Chung

et al. 2016

Arch Craniofac Surg

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Panfacial bone fracture is challenging. Even experienced surgeons find restoration of original facial architecture difficult because of the severe degree of fragmentation and loss of reference segments that could guide the start of facial reconstruction. To restore the facial contour, surgeons usually follow a general sequence for panfacial bone reduction. Among the sequences, the bottom-to-top and outside-in sequence is reported to be the most widely used in recent publications. However, a single sequence cannot be applied to all cases of panfacial fractures because of the variations in panfacial bone fracture patterns. In this article, we intend to find the reference and discuss the efficacy of inside-out sequence in facial bone fracture reconstruction.

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“…Panfacial fractures are usually caused by high-energy injuries (e.g., motor vehicle or gunshot injuries) [ 7 ]. Panfacial fractures account for 4%–10% of all facial fractures.…”

Section: Epidemiology Of Panfacial Bone Fracturementioning

confidence: 99%

Section: Various Sequences Of Panfacial Bone Reductionmentioning

confidence: 99%

Section: Various Sequences Of Panfacial Bone Reductionmentioning

confidence: 99%

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Panfacial Bone Fracture and Medial to Lateral Approach

Kim

Choi

Chung

et al. 2016

Arch Craniofac Surg

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“…The transverse frontal buttress is a complex structure formed by the frontal bone, frontal sinus, and supraorbital rim that determines the upper facial width and projection of the forehead (FIGURE 1). 58) As the horizontal frontal buttress, which forms the boundary between the mid-facial bone and the upper facial bone, is located at the bottom of the cranium, skull fractures are often accompanied by fronto-orbital buttress fractures. Forehead deformities are often caused by lack of treatment or incorrect restoration of the frontal buttress, so the underlying frontal buttress should be restored to its previous position to ensure that the previous forehead contour is restored in cases of complex depressed skull fractures (FIGURE 2 & 3).…”

Section: Introductionmentioning

confidence: 99%

Restoration of the Fronto-Orbital Buttress with Primary Bone Fragments

Kim

Kang

2019

Korean J Neurotrauma

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Objective Forehead deformities are often caused by lack of treatment or incorrect restoration of the frontal buttress, so the underlying frontal buttress should be restored to its previous position to ensure that the previous forehead contour is restored in cases of complex depressed skull fractures. However, since brain injuries from skull fractures could have fatal consequences, the clinical concern in primary surgery has been to save the patient's life, and cosmetic concerns have always been secondary. We retrospectively reviewed fronto-orbital fracture patients who underwent primary restoration with primary bone fragments or an alloplastic implant and compared the surgical outcomes of autologous bone (group 1) and artificial materials (group 2). Methods A retrospective review was conducted of 47 patients with fronto-orbital fractures between March 2012 and January 2018. The patients underwent primary reconstruction with primary bone fragments or an alloplastic implant. The surgical results were evaluated by the incidence of infection and cosmetic satisfaction of patients. Results Infections occurred in one patient (5%) in group 1 and in two patients (15.3%) in group 2, which was not a statistically significant difference. In contrast, at 6 months after surgery, patient satisfaction showed a statistically significant between-group difference (group 1: 4.32 points, group 2: 3.54 points, p =0.001). Conclusion Primary reconstruction using fractured bone fragments is an effective and preferable method that could result in better surgical outcomes than restoration using an alloplastic implant.

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“…trauma is associated with a concomitant cervical spinal injury, 8,9 however, this may be as high as 20% in panfacial trauma. 7 Evaluation of the cervical spine should be performed in these patients. 10 Any visual complaints, diplopia, pain with ocular movement, blindness, or hyphema indicate the need for an ophthalmology consult.…”

mentioning

confidence: 99%

Management of Panfacial Trauma: Sequencing and Pitfalls

Massenburg

Lang

2021

Semin Plast Surg

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Panfacial trauma refers to high-energy mechanism injuries involving two or more areas of the craniofacial skeleton, the frontal bone, the midface, and the occlusal unit. These can be distracting injuries in an unstable patient and, as in any trauma, Advanced Trauma Life Support (ATLS) protocols should be followed. The airway should be secured, bleeding controlled, and sequential examinations should take place to avoid overlooking injuries. When indicated, neurosurgery and ophthalmology should be consulted as preservation of brain, vision, and hearing function should be prioritized. Once the patient is stabilized, reconstruction aims to reduce panfacial fractures, restore the horizontal and vertical facial buttresses, and resuspend the soft tissue to avoid the appearance of premature aging. Lost or comminuted bone can be replaced with bone grafts, although adequate reduction should be ensured prior to any grafting. Operative sequencing can be performed from top-down and outside-in or from bottom-up and inside-out depending on patient presentation. All protocols can successfully manage panfacial injuries, and the emphasis should be placed on a systematic approach that works from known areas to unknown areas.

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Panfacial Fractures

Cited by 46 publications

References 20 publications

Panfacial Bone Fracture and Medial to Lateral Approach

Panfacial Bone Fracture and Medial to Lateral Approach

Restoration of the Fronto-Orbital Buttress with Primary Bone Fragments

Management of Panfacial Trauma: Sequencing and Pitfalls

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