These clinical studies reflect the experience of the author in managing 673 patients treated during the last 8 years. All patients were treated in the Maxillofacial Unit, Surgical Specialties Hospital, Medical City, Baghdad, and in the author's private clinic. Included patients were 530 males and 143 females; patients' age ranged between 1 year and 75 years (mean, 38 y). Distribution of
injuries was as follows: fracture of the mandible, 287 (42.64%); middle third
injuries, 39 (5.79%); orbital
injuries, 236 (35.07%; including 12 cases with cranioorbital
injuries);
injuries in children, 27 (4.0%); fracture of the zygoma, 52 (7.73%); and fracture of the nose, 40 (5.94%).
Maxillofacial injuries in this study were classified as follows: (1) craniomaxillofacial with
head injuries and
cerebrospinal fluid leak; (2) fracture of the middle third including Le Fort I, II, and III and midline split in the face; (3) fracture of the mandible as an isolated injury or as part of a facial skeleton injury; and (4) isolated complex
injuries of the zygoma, the orbital skeleton, and the nasoethmoidal region.The technique used for treating middle third
injuries was external fixation either by halo frame (with vertical rods and cheek wires) or by box frame (using 4 external pins connected by rods) or internal fixation by suspending the middle third with internal wires (0.5 mm
stainless steel) from the zygomatic process of the frontal bone beneath the zygomatic arch down the lower arch bar. Fractures of the mandible were treated by gunning
splint with intermaxillary fixation (IMF) or with open reduction and fixation by
stainless steel wire with IMF or by IMF screw or by an arch bar and IMF. Other fractures such as fracture of the orbit were treated by bone graft, sialastic, or lyophilized dura with open reduction. Fractures of the zygoma were treated by open reduction and fixation with
stainless steel wire and bone graft or by reduction without fixation. Fractures of the nose were treated by reduction with straightening of the septum with a
splint (lead
splint or
polythene) or by external
splint with
plaster of Paris. With the techniques used, results from managing these cases were satisfactory.