Presentation of multiple midface fractures combined with intracranial injury treated conservatively
Affiliation(s)
Department of Oral & Maxillofacial Surgery, Al-Ahli Hospital, Doha, Qatar. Department of Oral and Maxillofacial Surgery, Hamad Medical Corporation, Doha, Qatar.
Department of Oral & Maxillofacial Surgery, Al-Ahli Hospital, Doha, Qatar. Department of Oral and Maxillofacial Surgery, Hamad Medical Corporation, Doha, Qatar.
ABSTRACT
Midface injuries are normally the result of high forces impacted on the face, that can bypass the power of the connection buttresses, which are thick and strong, base of skull is also a rigid and toughstructure which requires significant forces to break. In our case, multiple midface and cranial base fractures are presented, which reflect injury caused by high forces and normally, these result in instability in the facial skeleton, or cause CSF rhinorrhea, or sharp spicules to endanger the orbit or the anterior cranial fossa, or the presence of any other indication of surgery. It is unusual to find such an extent of facial trauma and such a multiplication of fractures on the midface and cranial base levels, yet they were stable enough and without a real indication to require surgical interference.
Midface injuries are normally the result of high forces impacted on the face, that can bypass the power of the connection buttresses, which are thick and strong, base of skull is also a rigid and toughstructure which requires significant forces to break. In our case, multiple midface and cranial base fractures are presented, which reflect injury caused by high forces and normally, these result in instability in the facial skeleton, or cause CSF rhinorrhea, or sharp spicules to endanger the orbit or the anterior cranial fossa, or the presence of any other indication of surgery. It is unusual to find such an extent of facial trauma and such a multiplication of fractures on the midface and cranial base levels, yet they were stable enough and without a real indication to require surgical interference.
Cite this paper
Rane, T. , Nasser, F. and Taha, S. (2013) Presentation of multiple midface fractures combined with intracranial injury treated conservatively. Open Journal of Emergency Medicine, 1, 1-3. doi: 10.4236/ojem.2013.11001.
Rane, T. , Nasser, F. and Taha, S. (2013) Presentation of multiple midface fractures combined with intracranial injury treated conservatively. Open Journal of Emergency Medicine, 1, 1-3. doi: 10.4236/ojem.2013.11001.
References
[1] Hudson, et al. (1997) Experimentally induced upper facial third fractures in unembalmed human cadaver heads. The Journal of Trauma, Injury, Infection, and Critical Care Issue, 42, 705-710. http://dx.doi.org/10.1097/00005373-199704000-00021 [2] Nahum, A. and Melvin, J. (2001) Accidental injury, biomechanics and prevention. 276, Table 12.3. [3] Hodgson, V.R. (1967) Tolerance of the facial bones to impact. American Journal of Anatomy, 120, 113. http://dx.doi.org/10.1002/aja.1001200109 [4] Crandall, J.R., Kuhlmann, T.P. and Pilkey, W.D. (1995) Air and knee bolster restraint system: laboratory sled tests with human cadavers and the hybrid III dummy. Journal of Trauma, 38, 517-520. http://dx.doi.org/10.1097/00005373-199504000-00009 [5] Louis, P.J. (2004) Oral and maxillofacial surgery (Peterson). Management of Pan Facial Fractures, 8. [6] Moe K.S. (2012) Facial trauma, management of panfacial fractures. [7] (2009) Head and neck surgery. University of Washington School of Medicine. [8] Wenig, B.L. (1991) Management of panfacial fractures. Otolaryngologic Clinics of North America, 24, 93-101. [9] Tian, W., Li, S., Pan, J., Gao, Z. and Zheng, X. (1999) Surgical reduction and rigid internal Fixation of midface fractures. 17, 136-139. [10] Johnson, W. (2001) Oral and maxillofacial surgery. Fonseca, 4, Chapter 8. [11] Adeyemo, W.L., Taiwo, O.A., Ladeinde, A.L., Ogunlewe, M.O., Adeyemi, M.O. and Adepoju, A.A. (2012) Mid-facial fractures: A 5-year retrospective review in a Nigerian teaching hospital. Nigerian Journal of Medicine, 21, 31- 35. [12] Luce, E.A. (1987) Frontal sinus fractures, guidelines to management. Plastic and Reconstructive Surgery, 80, 500. http://dx.doi.org/10.1097/00006534-198710000-00003
[1] Hudson, et al. (1997) Experimentally induced upper facial third fractures in unembalmed human cadaver heads. The Journal of Trauma, Injury, Infection, and Critical Care Issue, 42, 705-710. http://dx.doi.org/10.1097/00005373-199704000-00021 [2] Nahum, A. and Melvin, J. (2001) Accidental injury, biomechanics and prevention. 276, Table 12.3. [3] Hodgson, V.R. (1967) Tolerance of the facial bones to impact. American Journal of Anatomy, 120, 113. http://dx.doi.org/10.1002/aja.1001200109 [4] Crandall, J.R., Kuhlmann, T.P. and Pilkey, W.D. (1995) Air and knee bolster restraint system: laboratory sled tests with human cadavers and the hybrid III dummy. Journal of Trauma, 38, 517-520. http://dx.doi.org/10.1097/00005373-199504000-00009 [5] Louis, P.J. (2004) Oral and maxillofacial surgery (Peterson). Management of Pan Facial Fractures, 8. [6] Moe K.S. (2012) Facial trauma, management of panfacial fractures. [7] (2009) Head and neck surgery. University of Washington School of Medicine. [8] Wenig, B.L. (1991) Management of panfacial fractures. Otolaryngologic Clinics of North America, 24, 93-101. [9] Tian, W., Li, S., Pan, J., Gao, Z. and Zheng, X. (1999) Surgical reduction and rigid internal Fixation of midface fractures. 17, 136-139. [10] Johnson, W. (2001) Oral and maxillofacial surgery. Fonseca, 4, Chapter 8. [11] Adeyemo, W.L., Taiwo, O.A., Ladeinde, A.L., Ogunlewe, M.O., Adeyemi, M.O. and Adepoju, A.A. (2012) Mid-facial fractures: A 5-year retrospective review in a Nigerian teaching hospital. Nigerian Journal of Medicine, 21, 31- 35. [12] Luce, E.A. (1987) Frontal sinus fractures, guidelines to management. Plastic and Reconstructive Surgery, 80, 500. http://dx.doi.org/10.1097/00006534-198710000-00003