SCARLESS REPAIR OF FACIAL FRACTURES

A 40-year-old man met with an accident while traveling on his two-wheelers on a highway, Injured his arm and the right side of his face. Civil court the basic first aid treatment done at a local medical center. Soon he realized that the right side of the face was swollen and to his surprise, there was reduced sensation over his cheek. He knew he had sustained some injury to his face and wanted it corrected.

He reported to the Richardsons Hospital with the specific complaint of reduced sensation over his right cheek giving the history of injury to his face due to an accident. A thorough clinical and radiological examination was done. It was concluded that the patient had sustained a fracture of the orbital rim and cheekbone. The nerve supplying the sensation over the cheek was entrapped between the fracture which was causing the decreased sensation.

He was explained the same and was given the option for the correction of the fracture which has to be done under general anesthesia.

The patient was taken up for surgery. Keeping in mind the aesthetics of the patient and the delicate nature of the skin surrounding the eye, an approach to reach the fracture site was taken through the conjunctiva of the lower eyelid. with this approach, the fracture was clearly seen and corrected. The entrapped nerve was identified and released. A titanium plate was placed and fixed with screws with dimensions of 1.5 mm to stabilize the fracture. Tiny sutures were placed which were resorbable. The patient's recovery was very good. He had no major complaints with regards to either pain or vision. But the best thing about the surgery was that it left no scars on his face. After a couple of weeks, his sensation has improved.

Orbital fractures are  a challenge to treat because of the approximately to the eye and the approach taken as the eyelids are very delicate. Dr. Sunil Richardson has operated on hundreds of orbital fractures in a scarless way with the best functional results.