Percutaneous Screws and External Fixation in Frontal Sinus Anterior Wall Fractures

Abstract

Fractures of the frontal sinus are frequently encountered injuries of maxillofacial fractures. The most common causes are traffic accidents, followed by sports-related injuries. There is still no consensus regarding the optimal management of frontal sinus fractures. The authors report a patient with depressed anterior wall fracture of the frontal sinus and superior orbital rim fracture. Reduction was performed by traction from 2 screws applied percutaneously to the depressed fragments and external fixation with an aluminum nasal splint. This technique is both minimally invasive and permits easy fixation in suitable patients.

An Endonasal Incision Adds a Second Vector of Manipulation During Percutaneous Reduction of Fractures Involving the Frontonasal Region

“…Other minimally invasive approaches that have been described include percutaneous screws with external fixation 13 and transcutaneous reduction with a periosteal elevator. 9 The use of an external screw handle (such as the Carroll-Girard screw) for reduction of the frontal sinus has previously been described by Yoo et al 7 They were able to obtain adequate reduction on all the patients in their series of 13 cases, but they do not specifically address what to do if this technique is not successful with tractional force alone.…”