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Case Report



Surgical management of 2/3 facial neglected fracture: A case report

Mitra Riswanda Hutabarat, Winarno Priyanto, Abel Tasman Yuza, Farah Asnely Putri.




Abstract
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Introduction: Maxillofacial fracture is a trauma that often occurs in patients with multiple trauma and can be life-threatening. Maxillofacial fractures can be considered a consequential injury accompanied by fractures of the skull base because they can result in death, severe morbidity, facial deformities, and functional limitations. More than 80% of trauma patients present in an emergency with a head injury. Case report: A 15-year-old male patient complained of limited upper and lower jaw movement. The patient had a history of a traffic accident two months before coming to the hospital with a decrease in consciousness, GCS 13. Clinical examination revealed deformity of the middle 2/3 of the face and mandible, malocclusion with an open bite in the anterior and posterior left mandible. Discussion: Fracture of 2/3 of the face is a complex case that requires surgical management. Reposition of fracture fragment, if not treated immediately, will cause the formation of misplacement soft callus or osteogenesis that cause malunion. The placement of the plates is adjusted to the vertical and transverse buttresses, as well as Champy's principle, to obtain maximum fixation so that the position of the bones can withstand the movement of the facial muscles. If surgical treatment is delayed, maximal deformity and surgery will become more difficult. Conclusion: Surgical management of maxillofacial trauma patients will give maximum results if reconstructive treatment is carried out immediately. Delay is a challenge for clinicians to restore facial function and aesthetics.

Key words: 2/3 facial fracture, Neglected fracture, Malocclusion, ORIF






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