Craniomaxillofacial fracture repair is a specialized surgical procedure targeting fractures of the skull and facial bones, primarily aimed at restoring the structural integrity and function of the bones. This treatment not only emphasizes the physical repair of fractures but also considers aesthetic symmetry and neurovascular protection. The surgery is typically performed at craniofacial surgical centers or craniofacial integrated medical facilities, with a personalized plan developed after assessment by a specialist physician regarding the type and severity of the fracture.
The key objectives of treatment include:
Traditional open surgery involves making incisions at the craniofacial site to directly remove fracture fragments and realign the bones. Surgeons use fixation materials such as plates, screws, or bone cement to ensure stable healing post-repair. This method is suitable for complex fractures with significant displacement or associated nerve damage.
Recent developments in endoscopic technology reduce tissue damage by inserting endoscopic instruments through small incisions to locate and fix fractures. This approach often combines 3D imaging navigation systems to enhance surgical precision and shorten recovery time.
Mainly applicable to craniofacial fractures caused by trauma (such as car accidents or falls), including:
Severe temporomandibular joint dislocation or complex zygomatic fractures are also common indications, requiring immediate surgery to prevent long-term sequelae.
The surgery is usually performed under general anesthesia, with duration depending on fracture complexity—minor fractures approximately 3-4 hours, while severe cases may extend beyond 6 hours. Postoperative care includes:
The choice of fixation materials depends on the fracture location; absorbable plates are common for nasal fractures, while stainless steel screws may be used for skull base fractures.
Main benefits include:
Minimally invasive techniques can reduce scarring and improve psychological well-being. Clinical studies report a surgical success rate of over 90%, with complication rates below 5%.
Potential risks include:
Serious complications include cerebrospinal fluid leaks or intracranial hemorrhage, which require immediate medical attention. Long-term sequelae may include joint stiffness or minor craniofacial deformities.
Special attention is needed in the following cases:
Contraindications include:
Differences from orthopedic surgery include considerations for facial aesthetics, potentially involving combined procedures with plastic surgery. Interactions with radiation therapy should be noted:
Coordination with dental treatments is necessary; invasive dental procedures should be avoided for at least six weeks after maxillary surgery.
According to a 2020 study in the journal Plastic and Reconstructive Surgery, patient satisfaction six months post-surgery reached 89%. Key indicators include:
Computer-assisted navigation technology has improved surgical accuracy to 97%, reducing the need for secondary surgeries.
Non-surgical treatments include:
However, in cases of severe displacement or nerve injury, non-surgical treatments have limited efficacy and may lead to permanent functional impairments.
What preparations are needed before surgery? What should be paid attention to on the day of surgery?
Preoperative assessments include full-body examinations and imaging scans to evaluate the severity of fractures and neurovascular injuries. Fasting for 6 to 8 hours before surgery is required, and all medical records should be brought. The surgeon will explain the surgical process and potential risks in detail. Patients must sign consent forms and agree to anesthesia methods.
How to alleviate facial swelling or pain after surgery? How long does it last?
Ice packs can be applied postoperatively to reduce swelling, with a towel used to prevent frostbite. Doctors will prescribe painkillers and antibiotics; self-medicating with other drugs is strictly prohibited. Swelling typically subsides within 1 to 2 weeks, but complete resolution may take months. Regular follow-up visits are necessary to monitor recovery progress.
What dietary restrictions should be observed after surgery? When can normal eating resume?
Initially, a liquid or semi-liquid diet is recommended, avoiding straws and hot foods. Hard foods or those requiring vigorous biting should be avoided for at least 4 to 6 weeks. The timing for resuming normal diet varies depending on individual injury and healing, and should follow the physician’s phased instructions.
When can daily activities be resumed? What movements should be avoided?
Light activities such as walking can typically begin after one week, but strenuous exercise or lifting heavy objects should be delayed at least six weeks. Avoid sleeping on the side that compresses the face, and refrain from rubbing or touching the wound area. If the zygoma or nasal bones are involved, actions like blowing air (e.g., blowing a harmonica) may affect bone fixation and should be carefully monitored.
What is the timing and method of postoperative rehabilitation?
Some patients require physiotherapy after suture removal to improve mouth opening or temporomandibular joint stiffness. Treatments include heat therapy, ultrasound, and gradual mouth opening exercises. The rehabilitation schedule depends on individual recovery and should be personalized in consultation with the physician.
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