Abstract

Facial trauma can assume complex patterns closely related to the mechanisms of injury, often associating soft tissue injuries with bone fractures, sometimes with important functional and esthetic impact. The approach of such complex injuries must be individualized and basic principles of diagnosis, preoperative planning, wound care and postoperative management must be applied. We present a case of unusual orofacial trauma involving a complex fracture of the maxilla with associated soft tissue lacerations, involving the alveolar process, hard palate, maxillary sinus and nasal floor with near-avulsion of the fragment which was pediculated only by the anterior vestibular mucosa. The approach and surgical treatment of this case is presented along with a discussion of the management of this type of injuries.

Facial trauma can assume many forms relating to the many different mechanisms involved, which can result in complex lesions. The combination of facial bone fractures and soft tissue trauma is often present, sometimes with important functional and esthetic impact. The approach of these complex trauma cases must be carefully selected and can represent a surgical challenge. While fractures of the midface and maxilla are commonly seen in facial trauma, hard palate involvement is relatively infrequent, and the ideal management of palatal fractures is still controversial. We present a case of unusual orofacial trauma involving a fracture of the maxilla and hard palate with disjunction and near-avulsion of the fragment, which was pediculated only by the anterior vestibular mucosa.