A Clinical Experience and Treatment of Panfacial Fracture

Kim, Jun Hyuk; Youn, Chang Yoon; Park, Eun Su; Tark, Min Seong; Lee, Young Man

Abstract

Panfacial fracture defines that fractures include all upper face, midface, and lower face. But clinically it means fracture more than two areas including midface. Many panfacial fracture patients have injury of cranium and face. Serious soft tissue damage and bony defect are frequent, normal anatomical reconstruction is difficult. After primary treatment many patients have sequelae of functional and aesthetic deformities, which are difficult to restore by secondary reconstruction. Patients with panfacial fracture are 75 cases among 1138 facial bone fractures who received treatment in department of plastic and reconstructive surgery of our university. We followed up survey from January, 1997 to December, 2001 by retrospective study and came to a conclusion. First, interconnection between skull base and nasal cavity must be seperated perfectly. Second, telecanthus can be prevented by anatomical bone fixation. Third, surgeon reconstruct zygomatic area exactly for facial width and projection. Forth, surgeon restore normal occlusion by anatomic reduction of maxilla and mandible. Fifth, soft tissue must be repaired layer by layer for prevention of secondary contour deformity. In conclusion, surgeon decides operation methods and time after discuss with related departments for with patient's condition. And treatment plans are based on patients mental and physical state. Proper primary treatment can reduce complications and necessity of secondary operation.