OBJECTIVE: To present the experience of characteristics and management of facial fractures in
a tertiary care Hospital in Islamabad, Pakistan.
METHODS: Study was conducted in the department of Plastic Surgery at Pakistan Institute of
Medical Sciences, Islamabad, Pakistan from January 2002 to December 2003. Only adult patients
of either sex were included who presented with facial fractures. Patients below 12 years
of age and those having only facial lacerations were excluded. In all cases, plain X-rays, OPG
(Orthopantomogram), Water’s view and CT scan (in more severe cases) were obtained. Majority
of the patients was operated on routine operation days (Monday to Saturday). All other fractures
were managed by Open Reduction Internal Fixation (ORIF) via intra-oral approach (gingivobuccal
incision). Only those fractures were approached from the external wound when the
wound lied on the line of fracture.
RESULTS: Total 133 fractures were noted in 96 patients. Most of the patients were males (76%)
with a male to female ratio of 3.1:1. Mean age of the patients was 36.5 years (range 13 – 79
years). The commonest cause was road traffic accident (53.1%) followed by assault (21.9%).
Mandible was the commonest facial bone to be involved (59.4%).. Various associated injuries
were also noted in these patients with facial lacerations (29.9%) being the most common. Various
treatment modalities were employed including Maxillo-Mandibular Fixation (n=37), lag
screws (n=21), microplates (n=23). The most frequent complication was pain and or lower lip
CONCLUSION: Patients with these injuries must undergo early interventions including reduction
and stabilization of fractures. Moreover, ORIF should also be undertaken wherever possible
not through an external approach but the intraoral approach.
Facial fracture. Maxillofacial trauma. Open reduction and internal fixation.