Secondary correction of the post-traumatic deformity: A clinical study

Abstract

The current manuscript explores the outcome of treatment for post-traumatic secondary deformities using the re-fracture of segments by osteotomies of the bone either at the fractured site or by the orthognathic osteotomies with repositioning to its premorbid place followed by internal fixation. A total of 14 patients were reported with post-traumatic secondary deformities of the craniofacial region to the Department of Facio-maxillary surgery from January 2019 - July 2022. All patients had varied clinical features including deranged occlusion, anterior open bite, difficulty in mastication, deviated nose, and depressed frontal bone. The radiological findings were mal-union, non-union, malocclusion, and failed implants. All patients were treated with osteotomies and internal fixation with titanium implants. The age range of patients with post-traumatic secondary deformity was from 17-45 years. The reasons for the secondary deformities that we experienced in our institute were excessive delay in initial treatment due to neurosurgical issues, financial issues and SARS-COVID-19, secondary infections due to the immunocompromised status of the patient, and failure of implants leading to non-union. At the end of 3 months follow-up, all patients had satisfactory results. The treatment for post-traumatic secondary deformities by re-osteotomising at the existing previous fracture site and doing reduction with internal fixation and orthognathic osteotomies for chronic malocclusion yields sufficient aesthetic and functional outcomes when there is no loss of hard or soft tissue.