Resumo

GUERRISSI, Jorge O.. Panfacial fractures: Treatment tming and strategy. Rev. argent. cir. [online]. 2017, vol.109, n.4, pp.1-10. ISSN 2250-639X.

Background: panfacial fractures are those that involve at least two of the three facial segmentis: frontal, medial third and jaw o mandibular area. Concomitant injuries (18 to 45%) afecting the ocular globe, endocranium and cervical spine are associated with panfacial lesions. Objectives: to describe the most frequent causes, facial areas involved and the right tming to initate the treatment sequence in 58 patentis with panfacial injuries treated at the Plastic Surgery Division of the Cosme Argerich Hospital. Material and methods: between 2000 to 2010, 720 patentis with facial trauma were treated. Of them, 68 (9,4%) presented panfacial fractures and 58 were included in this study. Results: the most afected areas were orbit and nose (68%); zygoma-malar (60%); maxilla (42%) and jaw (28%). The cranium was directly involved in 6 patentis ) (15%). The reconstructive method used in all cases was; 1. Open fracture expositon; 2. Reducton and fxaton by means of plates and screws; 3. Replacement of the comminuted bones with iliac autograf and no biologic material. According to the epicenter of the fracture and structural alteraton, the reconstructon was done from superior to inferior thirds (up-botom), 38 patentis; and from inferior to superior third (botom-up), 30 patentis, respectively. Conclusions: the Results were acceptable in 48 cases (85%) and inadequate in 9 (9%) according to facial harmony, aesthetic deformity, functonal sequels, complicatons and severity of secondary corrective operatons. The basic biomechanic needs were to obtain the recompositon of the midline, maintain the facial width and the lateral projecton of the face.

Palavras-chave : panfacial fractures, severe facial fractures, internal fxaton of the face..

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