Abstract
With the rapidly aging population in Japan, the incidence of oral and maxillofacial trauma in older people is increasing. In patients aged ≥90 years, multiple comorbidities, reduced physiological reserve, and age-related bone fragility often complicate the selection of an optimal treatment strategy. We encountered three cases of severe maxillofacial trauma in super-elderly patients aged 92, 96, and 102 years. One patient sustained a high-energy injury, while the other two were injured due to falling down and presented with complex fractures including Le Fort fracture, zygomaticomaxillary complex fractures, and mandibular condylar fractures. Open reduction and internal fixation were performed in close collaboration with other medical departments, 4-9 days post-injury. All patients had favorable post-operative outcomes, without complications, during follow-up. These cases suggest that, even in super-elderly patients, appropriate surgical management, combined with careful evaluation of systemic conditions, attention to local factors, and multidisciplinary coordination, can achieve good functional recovery. Maintaining pre-injury activities of daily living should be a key therapeutic goal when treating severe maxillofacial trauma in this cohort.
