Use of rigid external distraction device in treatment of complex maxillofacial fractures

Abstract

Collapse of maxillofacial skeletal structures after trauma results in inadequate anteroposterior projection and increase in facial width with deformed facial aesthetics and various functional problems. After successful use of rigid external distractor for treatment of congenital facial hypoplasia, they have been used for treating more complex craniofacial anomalies. Six patients with posttraumatic orbitozygomaticomaxillary deformity were managed with intraoperative and/or postoperative use of rigid external distractor device. All the patients maintained the early postoperative aesthetic and functional results in their follow-up period. All patients that the device kept applied in postoperative period tolerated the device. There were no complications related to use of rigid external distractor. Rigid external distractor device is a useful instrument in management of traumatic facial deformities and can be used (1) in controlled traction for reduction of impacted bony segments, (2) as external fixator to decrease the number of plates for fixation, (3) to overcome the soft tissue tension over bony structures to enable the use of smaller screw-plate systems, and (4) for fine adjustment of bony segments after operation depending on the needs of the case demonstrated with postoperative control computed tomographies.