Panfacial fractures: our experience

Villegas, D.; Lago, B.; Pagé, Isabelle; Sagüillo, Kora; García-Serrano, Guillermo; Flecha, F. Perez; Sánchez-Jaúregui, E.; González, J.; Eslava, J.M.; Acero, J.

doi:10.1016/j.ijom.2015.08.855

Cited by 2 publications

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“…Historically, these fractures were treated conservatively, which led to significant posttraumatic problems, including crippling malocclusion, significant increase in facial width, and decreased facial projection [ 1 ]. Treatment of PFFs can be difficult because of the apparent loss of all references for facial skeleton reconstruction, particularly in fractures interrupting the maxillary and mandibular arches, which should constitute recognizable occlusion and bone continuity [ 24 ]. As with other multiple fractures, it is necessary to outline a detailed plan before surgery to determine the buttresses to be reduced and the sequence of reduction for successful surgical management of PFFs.…”

Section: Discussionmentioning

confidence: 99%

Sequencing of panfacial fracture surgery: a literature review and personal preference

Yoon

Kang

Kim

2022

Arch Craniofac Surg

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Background: Treating panfacial fractures (PFFs) can be extremely difficult even for experienced surgeons. Although several authors have attempted to systemize the surgical approach, performing surgery by applying a unidirectional sequence is much more difficult in practice. The purpose of this study was to review the literature on PFF surgery sequence and to understand how different surgical specialists–plastic reconstructive surgery (PRS) and oral maxillofacial surgery (OMS)–chose sequence and review PFFs fixation sequence in clinical cases.Methods: The PubMed and Google Scholar databases were scoured for publications published up until May 2020. Data extracted from the studies using standard templates included fracture part, fixation sequence, originating specialist, and the countries. Bibliographic details like author and year of publication were also extracted. Also, we reviewed the data for PFFs patients in the Trauma Registry System of Dankook University Hospital from 2011 to 2021.Results: In total, 240 articles were identified. This study comprised 22 studies after screening and full-text analysis. Sixteen studies (12 OMS specialists and 4 PRS specialists) used a “bottom-top” approach, whereas three studies (1 OMS specialist and 2 PRS specialists) used a “top-bottom” method. However, three studies (only OMS specialists) reported on both sequences. In our hospital, there were a total of 124 patients with PFF who were treated during 2011 to 2021; 64 (51.6%) were in upper-middle parts, 52 (41.9%) were in mid-lower parts, and eight (6.5%) were in three parts.Conclusion: Bottom-top sequencing was mainly used in OMS specialists, and top-bottom sequencing was used at a similar rate by two specialists in literature review. In our experience, however, it was hard to consistently implement unidirectional sequence suggested by a literature review. We realigned the reliable and stable buttresses first with tailoring individually for each patient, rather than proceeding in the unidirectional sequence like bottom-top or top-bottom.

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Section: Discussionmentioning

confidence: 99%

Sequencing of panfacial fracture surgery: a literature review and personal preference

Yoon

Kang

Kim

2022

Arch Craniofac Surg

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“…Variations exist among these sequences but major consensus exists between the above two sequence, as it is the first point of fixation in panfacial fracture [2]. It is challenging for the surgeon to establish facial frame in all dimensions because panfacial fracture results in lack of reliable bony and soft tissue landmarks [3]. Failure to achieve proper reduction results in post-traumatic facial deformity [4].…”

Section: Introductionmentioning

confidence: 99%

Sequencing of Fixation in Panfacial Fracture: A Systematic Review

Rajendran

Palanivel

Narayanan

et al. 2020

J. Maxillofac. Oral Surg.

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Objective In panfacial fracture management, the controversy still exists in the sequencing of fixation. The purpose of this systematic review is to establish the best sequence pattern which assists in achieving definite facial width, vertical height and anteroposterior projection. Methods The review was conducted according to the ''Preferred Reporting Items for Systematic Reviews and Meta-Analyses'' (PRISMA) guidelines. Two independent authors performed a comprehensive search of the PUBMED, EBSCO, J-Gate, SCOPUS and NDH for articles published up until December 2018. Sequence of fixation, timing of intervention, outcome, follow-up period and complications were evaluated for patients with panfacial fracture. Results In total, 202 articles were identified from the databases. After screening and full text analysis, 25 studies were included in this systematic review. Nineteen studies reported bottom-to-top sequence and two studies reported top-to-bottom approach. However, four studies reported both the approaches. The follow-up period ranges from 3 weeks to 4 years. Conclusion Based on the literature support and evidence, good and satisfactory outcome achieved in ''Bottom-top and outside-in'' sequence when compared with other sequence pattern. Early repair of panfacial fracture is advised for proper reduction and fixation, but can be delayed in accompanying life-threatening injuries.Complications are perceptible in all the sequences; it can be avoided by definitive treatment planning and stepwise management.

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Panfacial fractures: our experience

Cited by 2 publications

References 0 publications

Sequencing of panfacial fracture surgery: a literature review and personal preference

Sequencing of panfacial fracture surgery: a literature review and personal preference

Sequencing of Fixation in Panfacial Fracture: A Systematic Review

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