J Korean Med Assoc.  2006 Sep;49(9):817-824. 10.5124/jkma.2006.49.9.817.

The Operation of Facial Bone Fractures

• Lee YH
• Jin US

• KMID: 2137822
• DOI: http://doi.org/10.5124/jkma.2006.49.9.817

Abstract

Plastic surgeons who perform reconstructive surgery of facial injuries have a dual responsibility: repair of the aesthetic defect and restoration of the function. The third goal is to minimize the period of disability. although emergent situations are limited in facial injuries, I would like to emphasize the advantages of prompt definitive reconstruction of the injuries and the contribution of early operative intervention to the superior aesthetic and functional outcomes. Socioeconomic and psychological factors make it imperative that an aggressive, expedient, and wellplanned surgical program be outlined, operated, and maintained to rehabilitate the patient to return to his or her active and productive life as soon as possible while minimizing aesthetic and functional disabilities. Teaching points: the techniques of extended open reduction and immediate repair or replacement of bone and microvascular tissue transfer of bone or soft tissue have made extensive and challenging injuries manageable. The principle of immediate skeletal stabilization in anatomic position has been enhanced by the use of rigid fixation and the application of craniofacial techniques that is safer and less traumatic for facial bone exposure. In this article, I will present mandibular fracture, orbital wall fracture and maxillar fracture, which are commonly encountered facial bone injuries. We can improve both the functional and aesthetic outcomes of facial fracture treatment when we manage the patients with the current concept of craniofacial techniques based on precise anatomic knowledge.

Keyword

Mandible fracture; Zygoma fracture; Maxilla fracture; Orbital fracture; Bone graft

MeSH Terms

Facial Bones*
Facial Injuries
Humans
Mandibular Fractures
Orbit
Orbital Fractures
Psychology

Figure

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  Figure 1 The angle and direction in mandiblular fracture A) vertical unfavorable, B) vertical favorable, C) horizontal unfavorable, D) horizontal favorable

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  Figure 2 53 years old male patient with mandible condylar fracture who has operation using external fixator A) Pre-operative 3D CT, B) Post-operative photo

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  Figure 3 Fixation points in zygoma fracture 1) zygomaticofrontal suture, 2) inferior orbital rim, 3) zygomaticomaxillary buttress, 4) zygomatic arch, 5) zygomaticosphenoidal suture

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  Figure 4 23 years old male patient with enophthalmos that is developed after reduction of zygoma fracture. For correction of enophthalmos, we performed onlay rib bone graft and lateral canthopexy A) A) Pre-operative, B) Post-operative, C) Pre-operative 3D-CT, D) Post-operative 3D-CT

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  Figure 5 Vertical buttress of facial bone

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  Figure 6 The mechanism of orbital blow-out fracture A) hydraulic theory, B) bone conduction theory

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  Figure 7 27 years old male patient with left orbital blowout fracture A) Pre-operative, B) Post-operative

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