Craniomaxillofacial Trauma & Reconstruction

6 pages, 440 KiB

Open AccessCase Report

Preoperative Planning of Virtual Osteotomies Followed by Fabrication of Patient Specific Reconstruction Plate for Secondary Correction and Fixation of Displaced Bilateral Mandibular Body Fracture

by Andreas Thor

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 188-193; https://doi.org/10.1055/s-0036-1572492 - 7 Mar 2016

Cited by 14

Abstract

This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the [...] Read more.

This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible. After segmentation, the mandible was virtually rotated back into position and the open bite was closed. A patient specific mandibular reconstruction plate was outlined and fabricated from the new virtual situation and the plate was thereafter installed utilizing the preoperative plan. Osteotomy- and drill-guides was used and thus simplified the surgery resulting in uneventful healing. Virtual planning and patient specific implants and guides were valuable in this case of secondary reconstructive trauma surgery. Full article

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7 pages, 235 KiB

Open AccessArticle

Review of Maxillofacial Hardware Complications and Indications for Salvage

by Jonatan Hernandez Rosa, Nathaniel L. Villanueva, Paymon Sanati-Mehrizy, Stephanie H. Factor and Peter J. Taub

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 134-140; https://doi.org/10.1055/s-0035-1570074 - 22 Dec 2015

Cited by 28

Abstract

From 2002 to 2006, more than 117,000 facial fractures were recorded in the U.S. National Trauma Database. These fractures are commonly treated with open reduction and internal fixation. While in place, the hardware facilitates successful bony union. However, when postoperative complications occur, the [...] Read more.

From 2002 to 2006, more than 117,000 facial fractures were recorded in the U.S. National Trauma Database. These fractures are commonly treated with open reduction and internal fixation. While in place, the hardware facilitates successful bony union. However, when postoperative complications occur, the plates may require removal before bony union. Indications for salvage versus removal of the maxillofacial hardware are not well defined. A literature review was performed to identify instances when hardware may be salvaged. Articles considered for inclusion were found in the PubMed and Web of Science databases in August 2014 with the keywords maxillofacial trauma AND hardware complications OR indications for hardware removal. Included studies looked at human patients with only facial trauma and miniplate fixation, and presented data on complications and/or hardware removal. Fifteen articles were included. None were clinical trials. Complication data were presented by patient, fractures, and/or plate without consistency. The data described 1075 fractures, 2961 patients, and 2592 plates, nonexclusive. Complication rates varied from 6 to 8% by fracture and 6 to 13% by patient. When their data were combined, 50% of complications were treated with plate removal; this was consistent across the mandible, midface, and upper face. All complications caused by loosening, nonunion, broken hardware, and severe/prolonged pain were treated with removal. Some complications caused by exposures, deformities, and infections were treated with salvage. Exposed plates were treated with flaps, plates with deformities were treated with secondary procedures including hardware revision, and hardware infections were treated with antibiotics alone or in conjunction with soft-tissue debridement and/or tooth extraction. Well-designed clinical trials evaluating hardware removal versus salvage are lacking. Some postoperative complications caused by exposure, deformity, and/or infection may be successfully treated with plate salvage. We propose an algorithm using this review and clinical expertise. We also propose that a national databank be created where surgeons can uniformly compile their patient information and examine it in a standardized format to further our understanding of clinical management. Full article

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3 pages, 163 KiB

Open AccessCase Report

Delayed Periorbital Abscess After Silicone Implant to Orbital Floor Fracture

by Raj Dedhia and Travis T. Tollefson

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 185-187; https://doi.org/10.1055/s-0035-1570075 - 21 Dec 2015

Cited by 6

Abstract

There is a lack of consensus regarding preferred implant materials for orbital floor fracture reconstruction, leading to surgeon- and institution-dependent preferences. A variety of implants are used for orbital floor fracture reconstruction, each with their own complication profile. Knowledge of different implant materials [...] Read more.

There is a lack of consensus regarding preferred implant materials for orbital floor fracture reconstruction, leading to surgeon- and institution-dependent preferences. A variety of implants are used for orbital floor fracture reconstruction, each with their own complication profile. Knowledge of different implant materials is critical to identifying complications when they present. We report a delayed periorbital abscess 5 years after orbital floor reconstruction using a silicone implant. Full article

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4 pages, 181 KiB

Open AccessCase Report

Large Septal Perforation Repair with Pericranial Flap and Intraoperative Fluorescence Angiography

by Ryan Williams, Matthew K. Lee and Sam P. Most

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 181-184; https://doi.org/10.1055/s-0035-1570073 - 21 Dec 2015

Cited by 4

Abstract

Septal perforations present a challenging dilemma for surgical intervention when medical therapy fails. Multiple techniques have been described in the literature to address perforations using numerous techniques; however, there have been varying rates of success and reproducibility reported. The use of a large, [...] Read more.

Septal perforations present a challenging dilemma for surgical intervention when medical therapy fails. Multiple techniques have been described in the literature to address perforations using numerous techniques; however, there have been varying rates of success and reproducibility reported. The use of a large, pericranial flap was previously described to repair large septal perforation. The objective of this case report is to describe the use of a pedicled pericranial flap in combination with intraoperative fluorescence angiography to quantify vascular perfusion. This article presents a 31-year-old man with an idiopathic, septal perforation measuring 1.7 × 1.7 cm who previously failed medical therapy and surgical repair. He underwent a combined, coronal incision and external rhinoplasty approach with a tunneled pericranial flap resulting in a successful repair. This case report illustrates robust reconstructive capability of pericranial flaps for repair of septal perforations, as well as the potential value of intraoperative fluorescence angiography in determining the likelihood of a successful outcome. Full article

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9 pages, 677 KiB

Open AccessArticle

The Application of Virtual Planning and Navigation Devices for Mandible Reconstruction and Immediate Dental Implantation

by Chingiz R. Rahimov, Ismayil M. Farzaliyev, Hamid Reza Fathi, Mahammad M. Davudov, Anar Aliyev and Emin Hasanov

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 125-133; https://doi.org/10.1055/s-0035-1566159 - 19 Nov 2015

Cited by 5

Abstract

Routine reconstruction of subtotal defects of the mandible and orthopedic rehabilitation supported by dental implants is achieved by means of detailed planning and lasts over a year. This article shows the outcomes of single-stage surgical treatment and immediate orthopedic rehabilitation performed with the [...] Read more.

Routine reconstruction of subtotal defects of the mandible and orthopedic rehabilitation supported by dental implants is achieved by means of detailed planning and lasts over a year. This article shows the outcomes of single-stage surgical treatment and immediate orthopedic rehabilitation performed with the help of preoperative virtual computer simulation. 3D investigation of pathological and donor sites, virtual simulation of tumor resection, positioning of the dental implants into fibula, virtual flap bending and transfer, virtual bending of fixing reconstruction plates, and fabrication of navigation templates and bridge prosthesis supported by dental implants were done preoperatively. The surgery included tumor resection, insertion of dental implants into fibula, elevation of fibula osteocutaneous free flap, rigid fixation within recipient site, and immediate loading by bridge orthopedic device. On 10-month follow-up, functional and esthetic results were asses as reasonable. Radiography showed dental implants to be integrated and positioned appropriately. We found that successful rehabilitation of the patients with extensive defects of the jaws could be achieved by ablative tumor resection, dental implants insertion prior to flap elevation guided by navigation templates, further osteotomy, modeling of the flap based on navigation template, flap transfer, and rigid fixation within recipient site by prebended plates, with application of prefabricated prosthesis. Full article

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6 pages, 369 KiB

Open AccessCase Report

The Big Bang: Facial Trauma Caused by Recreational Fireworks

by Josher Molendijk, Bob Vervloet, Eppo B. Wolvius and Maarten J. Koudstaal

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 175-180; https://doi.org/10.1055/s-0035-1566164 - 17 Nov 2015

Cited by 6

Abstract

In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with [...] Read more.

In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with severe blast injury to the face, caused by direct impact of rockets, and thereby try to contribute to the limited literature on facial blast injuries, their treatment, and clinical outcome. These patients require multidisciplinary treatment, involving multiple reconstructive surgeries, and the overall recovery process is long. The severity of these traumas raises questions about the firework traditions and legislations not only in the Netherlands but also worldwide. Therefore, the authors support restrictive laws on personal use of fireworks in the Netherlands. Full article

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5 pages, 324 KiB

Open AccessCase Report

Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve

by José Luis D'Addino, Laura Piccoletti, María Mercedes Pigni and Maria José Rodriguez Arenas de Gordon

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 170-174; https://doi.org/10.1055/s-0035-1563698 - 13 Nov 2015

Cited by 1

Abstract

The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and [...] Read more.

The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and infiltrated the skin, with easy bleeding. He had a history of hypertension, although controlled, was a 40-year smoker, had chronic atrial fibrillation, diabetes, and microangiopathy. During the consultation, the patient also presented with ocular obstruction due to an inability to open the eye. He mentioned having reduced vision. The computed tomography scan showed upper maxilla osteolysis without eye involvement. We underwent a radical resection in which upper maxilla and the anterior orbital margin were included. We used a Becker-type flap that allowed us to rebuild the cheek and to complete a modified neck dissection. Progress was favorable; the patient recovered ocular motility and his vision improved to 20/200. The final biopsy result was “malignant peripheral nerve sheath tumor, malignant schwannoma.” Malignant schwannoma of the peripheral nerve is extremely rare. The total resection and reconstruction being completed in one surgery represented a challenge due to the difficulty in obtaining tissues in addition to the necessity of an oncological resection. Full article

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4 pages, 79 KiB

Open AccessArticle

Tongue Blade Bite Test Predicts Mandible Fractures

by John Neiner, Rachael Free, Gloria Caldito, Tara Moore-Medlin and Cherie-Ann Nathan

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 121-124; https://doi.org/10.1055/s-0035-1567812 - 9 Nov 2015

Cited by 7

Abstract

The aim of the study is to evaluate the utility of a simple tongue blade bite test in predicting mandible fractures and use this test as an alternative screening tool for further workup. This is a retrospective chart review. An institutional review board [...] Read more.

The aim of the study is to evaluate the utility of a simple tongue blade bite test in predicting mandible fractures and use this test as an alternative screening tool for further workup. This is a retrospective chart review. An institutional review board approved the retrospective review of patients evaluated by the Department of Otolaryngology at a single institution for facial trauma performed from 1 November 2011, to 27 February 2014. Patients who had a bite test documented were included in the study. CT was performed in all cases and was used as the gold standard to diagnose mandible fractures. Variables analyzed included age, sex, fracture type/location on CT, bite test positivity, and operative intervention. A total of 86 patients met the inclusion criteria and of those 12 were pediatric patients. Majority of the patients were male (80.2%) and adult (86.0%; average age: 34.3 years). Fifty-seven patients had a negative bite test and on CT scans had no mandible fracture. Twenty-three patients had a positive bite test and a CT scan confirmed fracture. The bite test revealed a sensitivity of 88.5% (95% CI: 69.8–97.6%), specificity of 95.0% (95% CI:86.1–99%), positive predictive value [PPV] of 88.5% (95% CI: 69.8–97.6%), and negative predictive value [NPV] of 95.0% (95% CI: 86.1–99.0%). Among pediatric patients, the sensitivity was 100% (95% CI: 29.9–100%), specificity was 88.9% (95% CI: 68.4–100%), PPV was 75.0% (95% CI: 19.4–99.4%), and NPV was 100% (95% CI: 63.1–100%). The tongue blade bite test is a quick inexpensive diagnostic tool for the otolaryngologist with high sensitivity and specificity for predicting mandible fractures. In the pediatric population, where avoidance of unnecessary CT scans is of highest priority, a wider range of data collection should be undertaken to better assess its utility. Full article

4 pages, 329 KiB

Open AccessCase Report

A Rare Case Report of an Unusual Dislocation of Fractured Mandibular Condyle

by Madan Mishra and Gaurav Singh

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 166-169; https://doi.org/10.1055/s-0035-1566161 - 5 Nov 2015

Cited by 1

Abstract

Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left [...] Read more.

Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left condylar head was dislocated to the left anatomic angle of mandible. We have not found a single such case in the world English literature published till date. The presented case falls in the rarest of the rare category that will add to our previous knowledge about the types and extent of fracture dislocation of mandibular condyle. Full article

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4 pages, 213 KiB

Open AccessCase Report

Cross-Cheek Dumbbell-Shaped Radial Forearm Flap for Simultaneous Correction of Oral Cancer and Submucous Fibrosis

by Shreya Bhattacharya, Sivakumar Vidhyadharan, Krishnakumar Thankappan and Subramania Iyer

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 162-165; https://doi.org/10.1055/s-0035-1567811 - 5 Nov 2015

Cited by 2

Abstract

Simultaneous occurrence of oral submucous fibrosis along with carcinoma of the buccal mucosa is common. We report a novel technique of a single dumbbell-shaped, cross-cheek radial forearm free flap to repair bilateral defects caused by oral cancer resection on one side and the [...] Read more.

Simultaneous occurrence of oral submucous fibrosis along with carcinoma of the buccal mucosa is common. We report a novel technique of a single dumbbell-shaped, cross-cheek radial forearm free flap to repair bilateral defects caused by oral cancer resection on one side and the release of fibrosis on the other side in two patients. The dumbbell-shaped flap provided tissue for both the buccal mucosa defects and central released soft palate preventing fibrosis and reapproximation. The interincisor distance improved in both the patients. Full article

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4 pages, 175 KiB

Open AccessCase Report

Deformation of a Titanium Calvarial Implant following Trauma: A Case Report

by Valerie R. De Water, Ellianne J. dos Santos Rubio, Joost W. Schouten and Maarten J. Koudstaal

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 158-161; https://doi.org/10.1055/s-0035-1567810 - 5 Nov 2015

Cited by 3

Abstract

Alloplastic material is widely used for the reconstruction of calvarial defects. The objective of this article is to describe the effect of mechanical impact on a titanium calvarial implant and to discuss mechanical properties of alternative implant materials. The patient is a 19-year-old [...] Read more.

Alloplastic material is widely used for the reconstruction of calvarial defects. The objective of this article is to describe the effect of mechanical impact on a titanium calvarial implant and to discuss mechanical properties of alternative implant materials. The patient is a 19-year-old man who was involved in a traffic accident and underwent decompressive craniectomy for an extensive subdural hematoma. Reimplantation of the skull flap was complicated by infection and the flap had to be removed. The remaining cranial defect was closed with a titanium plate. The recovery was without complications. One year later, the patient was hit on the titanium plate, during a soccer match, by the elbow of a fellow player. The implant deflected inward, leaving a visible indentation of the cranial vault. Fortunately, there were no significant neurological symptoms and radiography did not show any signs of damage or pressure on the brain parenchyma. The patient had no aesthetic complaints regarding the shape. Thus, there was no indication to remove the plate. This case illustrates the limits of the protection offered by titanium cranioplasty. Full article

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8 pages, 523 KiB

Open AccessArticle

Autologous Fat Transfer for Esthetic Contouring of Face in Posttraumatic Nonfunctional Maxillofacial Deformities

by Kapil S. Agrawal, Manoj Bachhav, Charudatta S. Naik, Harshwardhan Tanwar and Shilpa S. Sankhe

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 113-120; https://doi.org/10.1055/s-0035-1566163 - 5 Nov 2015

Cited by 14

Abstract

The transfer of autologous fat has been performed since the 1890s; however, its popularity has increased owing to better understanding of fat harvesting and processing techniques. In this article, fat grafting procedure has been used to correct posttraumatic facial deformities in 25 cases. [...] Read more.

The transfer of autologous fat has been performed since the 1890s; however, its popularity has increased owing to better understanding of fat harvesting and processing techniques. In this article, fat grafting procedure has been used to correct posttraumatic facial deformities in 25 cases. As healing of grafted fat is unpredictable, we have used longer follow-up of 2 years. Evaluation was performed using facial photographs and MRI scans. Scientific literature describes an absorption rate ranging from 20 to 90%. High fat graft resorption rates have been attributed to traumatic handling of the graft during harvest, processing, and injection. Various processing techniques have been suggested. The goal of these techniques is to obtain greater adipocyte cell survival and, consequently, more reliable clinical results. In our study, we have used syringe aspiration and low-speed centrifuge for processing of fat which has resulted in good clinical outcomes. Full article

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4 pages, 80 KiB

Open AccessArticle

Lower Eyelid Malposition Following Orbital Fracture Surgery: A Retrospective Analysis Based on 198 Surgeries

by Alexandra G. Kesselring, Paul Promes, Elske M. Strabbing, Karel G. H. van der Wal and Maarten J. Koudstaal

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 109-112; https://doi.org/10.1055/s-0035-1567813 - 3 Nov 2015

Cited by 16

Abstract

The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and [...] Read more.

The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and 2011. Preoperative and postoperative presence of lower eyelid malposition of patients was reported. The types of incision used for access were as follows: approach via laceration (4.5%), via preexisting scar (16.2%), infraorbital (40.9%), subciliar (23.7%), transconjunctival (13.1%), and transconjunctival with lateral canthotomy (1.5%). The incidence of ectropion development following surgery was 3.0% and the incidence of entropion development following surgery was 1.0%. The highest rate of ectropion (11.1%) was seen using an approach via a laceration, followed by approach via a scar (6.3%). Our conclusion is that the transconjunctival incision without a lateral canthotomy has a low complication rate, provides adequate exposure, and leaves no visible scar. Full article

4 pages, 115 KiB

Open AccessArticle

Tomographic Evaluation of Mandibular Thickness on Premolar and Molar Regions Related to Monocortical Screws

by Jonathan Ribeiro, Charles Marin, Nicolas Homsi, Hernando Rocha Junior, Luiz Magacho, Guto Fidalgo and Manuella Zanela

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 105-108; https://doi.org/10.1055/s-0035-1566162 - 28 Oct 2015

Cited by 3

Abstract

The aim of this study was to measure the thickness of the mandible from the external cortical plate to the teeth roots on premolar and molar regions using CT scan to determine the safety margin for the application of monocortical screws for internal [...] Read more.

The aim of this study was to measure the thickness of the mandible from the external cortical plate to the teeth roots on premolar and molar regions using CT scan to determine the safety margin for the application of monocortical screws for internal rigid fixation. Thirty-one patients underwent CT-scan imaging for surgical planning. The images were used to measure bilaterally the distance from the external cortex of the mandible to the roots of teeth on premolar and molar region by means of Dental Slice software (Bioparts Prototipagem Biomedica, Brasília, DF, Brazil). Mean, median, standard deviation, one-way ANOVA and post hoc Tukey's test were used for statistical analysis. No statistical differences for thickness were found between right and left side (p = 0.1652). The mean thickness for the left side was 4.17 ± 1.68 mm and for right side 3.93 ± 1.49 mm. Increase in mandibular thickness from anterior to posterior regions in both sides was observed and statistical difference was found among the different groups according to the measured region (p < 0.05). The present results can predict the safety zone for the use of monocortical screws in the mandible, but the use of CT scan is imperative and individual analysis is desired owing to anatomical variations. Further studies with larger samples are necessary to confirm these data and should include other anatomic structures, different regions of mandible/maxilla, as well as other ethnic groups. Full article

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3 pages, 161 KiB

Open AccessCase Report

Condylar Fracture in a Child with Entrapment of the Inferior Alveolar Nerve

by Constantinus Politis, Yi Sun, Jimoh Agbaje, Ivo Lambrichts, Maria Piagkou and Reinhilde Jacobs

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 149-151; https://doi.org/10.1055/s-0035-1563391 - 18 Aug 2015

Abstract

The aim of this article is to report the clinical case of a right subcondylar fracture in a 4-year-old boy. The displaced and medial angulated fragmented mandibular condyle in coexistence with an enlarged lateral pterygoid process was compressing the inferior alveolar nerve (IAN) [...] Read more.

The aim of this article is to report the clinical case of a right subcondylar fracture in a 4-year-old boy. The displaced and medial angulated fragmented mandibular condyle in coexistence with an enlarged lateral pterygoid process was compressing the inferior alveolar nerve (IAN) during its course in the area of the infratemporal fossa. This was expressed by exhibiting a rubbing behavior with resulting superficial ulceration at the right lower lip. Hypoesthesia of the lower lip may be a sign of the IAN entrapment after a subcondylar fracture in a child. In contrast to the adults where an open reduction is necessary to relieve the symptoms of hypoesthesia, in pediatric population, a conservative approach seems sufficient. Full article

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6 pages, 301 KiB

Open AccessCase Report

Orbital Compartment Syndrome Leading to Visual Loss Following Orbital Floor Reconstruction

by Srinivas M. Susarla, Arthur J. Nam and Amir H. Dorafshar

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 152-157; https://doi.org/10.1055/s-0035-1558456 - 24 Jul 2015

Cited by 8

Abstract

Reconstruction of posttraumatic orbital defects carries the attendant risk of injury to the ocular adnexa, globe, and associated neurovascular structures. Blindness following repair of orbital fractures is an infrequent but well-documented phenomenon. Visual acuity loss can be related to direct intraoperative injury to [...] Read more.

Reconstruction of posttraumatic orbital defects carries the attendant risk of injury to the ocular adnexa, globe, and associated neurovascular structures. Blindness following repair of orbital fractures is an infrequent but well-documented phenomenon. Visual acuity loss can be related to direct intraoperative injury to the optic nerve, retinal arterial occlusion, or delayed presentation of acute optic nerve injury. In this report, we document a unique case of acute optic nerve infarction occurring 14 h following orbital floor exploration and repair in a 56-year-old man. Full article

4 pages, 214 KiB

Open AccessCase Report

Transorbital Orbitocranial Penetrating Injury with an Iron Rod

by Amit Agrawal, V. Umamaheswara Reddy, S. Satish Kumar, Kishor V. Hegde and G. Malleswara Rao

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 145-148; https://doi.org/10.1055/s-0035-1551545 (registering DOI) - 21 May 2015

Cited by 13

Abstract

Transorbital orbitocranial penetrating injuries (TOPIs) are relatively rare, can be caused by high-speed projectile foreign bodies to low-energy trauma (which is rarer), and account for 24% of penetrating head injuries in adults and approximately 45% in children. We report an uncommon nonfatal case [...] Read more.

Transorbital orbitocranial penetrating injuries (TOPIs) are relatively rare, can be caused by high-speed projectile foreign bodies to low-energy trauma (which is rarer), and account for 24% of penetrating head injuries in adults and approximately 45% in children. We report an uncommon nonfatal case of TOPI where a 16-year-old male child sustained injury due to accidental penetration of metal bar into the forehead. A bicoronal flap was raised to remove the metal bar. The patient recovered well, had normal vision, and doing well at follow-up. Full article

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4 pages, 114 KiB

Open AccessCase Report

Osteogenesis Imperfecta Diagnosed from Mandibular and Lower Limb Fractures: A Case Report

by Yoshikazu Kobayashi, Koji Satoh and Hideki Mizutani

Craniomaxillofac. Trauma Reconstr. 2016, 9(2), 141-144; https://doi.org/10.1055/s-0035-1550063 (registering DOI) - 27 Apr 2015

Cited by 2

Abstract

Osteogenesis imperfecta (OI) is a congenital disease characterized by bone fragility and low bone mass. Despite the variety of its manifestation and severity, facial fractures occur very infrequently. Here, we report a case of an infant diagnosed with OI after mandibular and lower [...] Read more.

Osteogenesis imperfecta (OI) is a congenital disease characterized by bone fragility and low bone mass. Despite the variety of its manifestation and severity, facial fractures occur very infrequently. Here, we report a case of an infant diagnosed with OI after mandibular and lower limb fractures. A boy aged 1 year and 3 months was brought to his neighboring hospital with a complaint of facial injury. He was transferred to our hospital to undergo operation 3 days later. Computed tomography images revealed multiple mandibular fractures including complete fracture in the symphysis and dislocated condylar fracture on the right side. Open reduction and internal fixation with absorbable implants was performed 7 days after injury. He fractured his right lower limb 2 months later. He was diagnosed with OI type IA by an orthopedist. He will be administered bone-modifying agents if he suffers from frequent fractures. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 9, Issue 2 (June 2016) – 18 articles

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