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Complex Maxillary Fractures: Role of Buttress Reconstruction and Immediate Bone Grafts
Abstract
Between 1978 and 1984, 558 patients with complex facial fractures have been treated. One hundred and seventy-one of these patients have had complex Le Fort fractures of the maxilla. In this group of patients, the importance of direct anatomic reconstruction of the anterior maxillary buttresses has been assessed. Complete exposure of the injured buttresses will facilitate assessment of the exact fracture pattern. Direct fixation of the medial and lateral maxillary buttresses on each side, in combination with immediate bone-graft reinforcement or replacement of comminuted or missing buttresses, will facilitate the reconstruction of even the most severely injured maxilla in one stage. This approach is combined with similar reconstructive techniques in other areas of the craniofacial skeleton. Associated mandibular fractures are managed with rigid internal fixation utilizing A-O techniques. The use of these techniques dramatically facilitates airway management and simplifies the treatment of the edentulous patient, the patient with bilateral condylar neck fractures, and those patients with sagittal splitting of the maxilla and palate. The use of both internal craniofacial suspension wires and external craniofacial suspension devices has become largely unnecessary, and reconstruction of even the most complex injuries in one stage with minimal complications and secondary deformities is made possible.
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“The established buttresses of the upper jaw and midface form a critical foundation for stable osteosynthesis using patient-specific subperiosteal implants, enabling immediate dental rehabilitation [17].”
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Metadata
- Authors
- Grass, J. S., & Mackinnon, S. E.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- ORCID
- Mackinnon, Susan E.
- Venue
- Plastic and Reconstructive Surgery
- Published
- 1986-07
- Volume
- 78
- Issue
- 1
- Pages
- 9-22
- ISSN
- 0032-1052 (ISSN-L)
- OpenAlex
- W2036558318
- Cited by
- 212
- References
- 0
- Citations by year
- 2025: 4 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 8 · 2019: 3 · 2018: 10 · 2017: 7 · 2016: 9 · 2015: 4 · 2014: 11 · 2013: 11 · 2012: 4
- FWCI
- 5.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Plastic & Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Facial Trauma and Fracture Management
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
- Keywords
- Le Fort fractures, bone grafting, rigid internal fixation, mandibular fractures, sagittal split ramus osteotomy, airway management, edentulous patients, one-stage reconstruction
- MeSH terms
- Bone Wires, Female, Fracture Fixation, Internal, Humans, Male, Maxilla, Maxillary Fractures, Maxillofacial Injuries, Methods, Postoperative Complications, Bone Transplantation
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