抄録
A case of a fresh open comminuted maxillofacial fracture is presented.
This 38 year-old male, who was on a motor cycle and struck in the left side of the face by a parking car on April 12, 1982 was trasferred to an emergency service of our hospital on the following day with a diagnosis of fractures of the fibula and the pelvis, and face laceration. Physical examination on admission disclosed that his consciousness was clear. There was a laceration in the left cheek through which the maxillry sinus was open.
A comminuted fracture of the maxilla with a longitudinal fracture of the palate and 2-6 alveolar bone fracture were revealed by X-ray and CT scan. Fracture of the fibula and the pelvis were treated nonoperatively. An open reduction for this maxillofacial fracture was immediately performed under a general endotracheal anesthesia. The main purpose of this operation was functional correction of occlusion. Bone fragments were brought into the occlusion and intermaxillary fixation with splints was performed. A radical operation of the maxillary sinus was subsequently carried out through the cheek laceration. A drain was placed through the nasal cavity. Intermaxillary fixation was continued for 50 days postoperatively.
The patient obtained a normal occlusion. He is quite satisfied cosmetically as well as functionally.
When managing a trauma patient with a maxillofacial injury, the functional reduction of the maxillofacial fracture should be considered soon after life support care.
The difficulty in a quick assessment for the minimum requirement in the treatment of the maxillofacial injury among other priorities was summarized.
