Two hundred ninety-four consecutive facial fractures in an urban trauma center: lessons learned

Abstract

Learning objectives: After studying this article, the participant should be able to: 1. Understand the different technical options available for repairing facial fractures. 2. Know which technical points facilitate performance of fixation of the facial skeleton by relatively inexperienced surgeons. 3. Have a basic understanding of the most common complications arising after facial fracture repair. 4. Have an understanding of how to avoid surgical complications following facial fracture repair.

Background: The treatment of facial trauma is associated with a myriad of potential complications. This may be compounded by the relative lack of compliance seen in the patient population within an urban trauma center and by the requisite involvement of residents in this care.

Methods: This study retrospectively evaluated 189 patients with a total of 294 separate fractures treated over a 3.5-year period.

Results: The overall rate of complications was 7.8 percent.

Conclusions: The experience at a high-volume level I trauma center with residents as the primary physicians has confirmed that facial trauma surgery may be undertaken with an acceptably low complication rate. Numerous technical factors were thought to be responsible for this, including the use of miniplates for treatment in the majority of mandibular fractures, overcorrection of orbital volume in fractures involving the globe, and the use of a transconjunctival incision with a lateral canthotomy for access to the lower eyelid structures.