Objective : The aim of this study was to analyse the principal variables which determine the method of treatment and outcome in traumatic injuries in sequelae of craneofacial fractures.
Methods : Twenty politraumatized patients with sequelae in craneofacial injuries were included in this experience. They were divided in two groups. First Group: 10 patients with sequelae in craneofacial fractures. Second Group: ten patients with sequelae in midface fracture. Etiology, surgical methods and the occurrence of long term sequelae were investigated in both groups at all. Open approach reducction and osteosynthesis were realised in all the cases using titanium microplates and titanium mesh with screws. Some cases need porous polyethylene sheets (Medpor, Porex Surgical Inc.) and acrylic biomaterials. This expierence was done throughout a period of four years. Data were analyzed using standard statistical methods.
Results : (1) The main etiologies were assault (58%) and falls (42%). (2) Gender distribution of the patients was 80% males and 20% female, with a mean age of 36 years old. (3) Postoperative followed up by X-ray waters view and CT scans verified anatomic reduction and osteosynthesis adequate. (4) A successful outcome of the treatment was achieved in spite of the methodological variations and the difference in the biomaterials used in each patient.
Conclusions : – Therapeutics objectives were reached by both groups. – Inadequate diagnostic and poor techniques of treatment have the potential for postoperative sequelae. – The degree of reduction and remaining dislocation of craneofacial fractures is important to achieve a good postoperative result that is reducing postoperative symptoms. – Furthermore the type of fracture also influences the patient’s long term sequelae. – A specially designed treatment plan for each patient is necessary. – General rules do not apply in resolutions of sequelae craneofacial fractures.