Fracture of teeth and supporters alveolar bone Arch bar wiring

Mandibular fracture achieve facial symmetry

Tx: conservative therapy, to intermaxillary fixation to ORIF/OREF

Maxillary fracture to obtain occlusion

Tx: bone lesion > 5mm  bone graf

Orif

Nasal Fracture Ample, nondisplaced Digital reduction with/without instrumentation or

anaesthesia intranasal
padding is required

septal realignment using forceps/dingman septal

Acute displacement displacer
Open rhinoplasty starts with upper vault, middle than
Complex injuries
lower vault
Total nasal collapse Bone/cartilage graf maybe needed

Orbitozygomatic fracture ophthalmologic connet

Simple zygomatic arch fracture  reduction witg dirgman elevator

Complicated fractures  miniplates fixation

Bone lesion > 5mm  bone graf

Nasoethmoid orbital fracture nasopyramid displacement

Type I  single fragment connected to medial canthus

Type II multiple fragment, 1 single bone segment connected

to canthus  used for reconstruction

Type III  comminution of bone, fractures extend beneath the

canthal tendon insertion  require bone graf

Orbital fracture diplopia, unevenness of two eyes, enophthalmus, difficulty in upward rotation

of the eyes, paralysis nervus III, IV & VI

Implants/Mesh media for reconstruction

Specific injuries Gunshot wound injuries
Sof tissue and bone not much damage  fractures are
Low velocity reduced and fixed, sof tissue excised, closed and
drained
Severe tissue lost  serial debridement, if condition
High velocity severe, distinctive surgery done within 48 hours

Pediatric facial fractures greenstick reduction without fixation

Minimally displaced conservative

Reduced and fixed  considered
Severly displaced
growth disturbance