Effective Management of Panfacial Fractures in a Craniofacial Trauma Center: A Retrospective Study.

Abstract

Introduction: Panfacial fractures are caused by high-impact trauma and represent the most severe injuries to the face. The combination of these fractures determines the treatment strategy. The objective of this study was to analyze the treatment protocol for panfacial fractures at the Centro Médico ISSEMYM, to describe a new proposed protocol for the management of panfacial fractures and analyze the complication rate associated with this protocol.

Patients and methods: Eighteen patients with panfacial fractures were treated between January 2014 and June 2024. After clinical and radiological examination, patients with panfacial fractures defined as: fractures of at least 2 of the 3 facial thirds: upper facial third, middle facial third, and lower facial third were included in this study. The authors reviewed in-hospital medical records to collect data on the medical history, cause of injury, fracture location, treatment sequence, postoperative complications, duration of hospital stay, and computed tomography scans.

Results: The average age of patients was 45 years. The etiology of trauma was predominantly traffic accidents. A total of 108 fractures were recorded in 18 patients. Eight patients (44%) had frontal fractures (7%), 13 patients (72%) had mandibular fractures (18%), and all patients had fractures of midface in different combinations. Postoperatively, buccal occlusion was satisfactory. Computed tomography scans were taken to assess the adequacy of fracture reduction and fixation.

Conclusion: The sequence used in the authors' center is safe, reliable and has shown adequate results, and also allows for adequate correction for this type of trauma in a single surgical procedure.