Midface trauma

Aneesh came to us after having suffered a major road traffic accident two days back. His condition was stabilized at a nearby primary care set up after which he was referred to us for management of his facial fractures.

He was examined by the team of facio-maxillary surgeons  led by Dr.Sunil Richardson. He had facial swelling, bruising of both the eyelids, conjunctival ecchymosis(blood collection), limited mouth opening and completely deranged occlusion(bite). A Cone beam CT scan was done for him.

The scan revealed lefort 1 and 3 fractures of both sides. It meant his upper jaw

bone were fractured from its skeletal base and even the nasal bones and orbital bones were affected. He would need fixing of his fractures by mini plates and screws.

After a pre-surgical workup, he was taken into the Operation theatre. In a surgery that lasted two hours, his upper jaw was fixed, occlusion normalized, orbital floor fracture fixed and mouth opening increased. Small mini plates were used made of bio-inert metal. No external incisions were given. An arch bar was also fixed for the fracture involving his dental arch(upper).

He resumed semi-solid diet one day after the surgery. The pain was effectively controlled with medications. Oral hygiene instructions were strictly adhered to. His occlusion and mouth opening became perfectly normal.