Category: Facial Bone Fracture

Fixation of 6 months old malunited fracture of right cheek bone intraorally to avoid scar formation

2/3/2015

A 20 year old boy came to our hospital with the complaint of fractured facial bone on the right side due to vehicular accident 6 months back. He was complaining of facial asymmetry due to posterior displacement of fractured cheek bone.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S.M.Balaji diagnosed fractured and malunited right body of zygoma. This led to facial asymmetry. To avoid scar formation, intraorally through sulcular incision wrongly united zygoma was exposed, refractured, elevated and fixed using 4 hole titanium bone plate. This improved his appearance dramatically. Patient was very happy to have fractured facial bone fixation without any surgical marks.

Preoperative 3DCT scan showing right body of zygoma fracture

Preoperative 3DCT scan showing fractured and malunited right body of zygoma

Fractured zygomatic bone exposed intraorally through sulcular incision

4 hole titanium bone plate was used to fix the refractured segments into its normal position

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Complete facial rehabilitation in a complex facial bone fracture

16/2/2015

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This is a case of multiple facial bone fracture due to road traffic vehicular accident happened 5 months back. The patient had first aid treatment and fractured bone stabilization at nearby hospital elsewhere. But he was not happy with the surgical outcome where left eye was at a lower level compared to the right side. He was not able to bite properly which made him very uncomfortable.

On examination, facial appearance was completely changed and he was not able to bite properly due to improperly united maxillary and Mandibular fracture segments. Left Mandibular canine and lateral incisor teeth were fractured and canine crown was displaced in between the fracture margins of the mandible which was not removed in the previous surgery done elsewhere.

After thorough clinical and radiological examination, Maxillofacial surgeon Dr. S. M. Balaji diagnosed that his left lateral orbital rim and zygomatic arch were fractured and laterally displaced. Maxilla and mandible also were fractured and wrongly united which led to improper bite. Dr. Balaji planned to correct his facial appearance and bite in a single surgery. Intraorally the impacted canine crown was removed along with the fractured lateral incisor and replaced with dental implants. Both upper and lower jaw stabilized and fixed in proper occlusion. Lateral orbital rim was also brought medially by intraocular incision and floor of the orbit was raised using titanium mesh. Thus the fractured facial bones were corrected in such a way that gave an improved appearance without any visible scars on his face.

Preoperative view showing depressed left orbital content

3DCT scan view showing multiple facial bone fractures stabilized with bone plates

Malunited fracture margins of mandible and displaced canine crown into the fractured segments

Displaced canine crown was exposed intraorally and the fracture segments were approximated

Canine crown was removed in toto

Fractured left lower lateral incisor and canine teeth were extracted and dental implants fixed into the sockets

Displaced portion of left lateral orbital rim was approximated into its correct position

Entire orbital content was raised and made symmetrical with that of the right side using titanium mesh.

Immediate postoperative view showing raised left eye and made symmetrical without any damage to the orbital content

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Fixation of fractured and displaced facial bone intraorally to avoid scar formation

23/12/2014

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A 20 year old boy came to our hospital with the complaint of fractured facial bone on the right side due to vehicular accident. He was complaining of facial asymmetry due to medial displacement of fractured cheek bone.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S.M.Balaji diagnosed fractured right body of zygoma with medial displacement. This led to facial asymmetry. To avoid scar formation, intraorally through sulcular incision fractured zygoma was exposed, elevated and fixed using 4 hole titanium bone plate. This improved his appearance dramatically. Patient was very happy to have fractured facial bone fixation without any surgical marks.

Preoperative 3DCT scan showing right body of zygoma fracture and its medial displacement

Fractured zygomatic bone exposed intraorally through sulcular incision

4 hole titanium bone plate was used to fix the fractured segments

Comments

Fixation of 6 months old malunited fracture of right cheek bone intraorally to avoid scar formation

Complete facial rehabilitation in a complex facial bone fracture

Fixation of fractured and displaced facial bone intraorally to avoid scar formation

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