With little in the published literature on the conservative management of facial fractures we set out to determine whether our current criteria for treatment are valid.
Two hundred and thirty adult patients with fractures of the facial skeleton were treated conservatively by our unit between February 1997 and January 2003. Their notes were reviewed retrospectively.
Most patients were males (76%), the average age was 38 years, and drugs or alcohol were a significant aspect of the history in 30% of the cases. The most common mechanism of injury was assault (47%), followed by falls and sporting injuries. Fifty percent of the fractures involved the orbital or orbito-zygomatic complex, and 55% had associated injuries. Average follow-up was for six weeks (range 0–44 weeks). Most patients were managed conservatively based on our current criteria of un-displaced/minimally displaced fracture (57%); or minimal/no symptoms (24%). At final review, a number had residual symptoms, but only three required corrective surgery. The other reasons for conservative management included patient non-compliance (11%), and medical contraindications (8%).
Our results support current indications for the conservative management of facial fractures, but emphasise the need for ongoing follow-up of these patients.
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- Treatment of fractured mandibular condylar processes in children.Br J Plast Surg. 1965; 18: 423-427
- Comparison of functional recovery after nonsurgical and surgical treatment of condylar fractures.J Oral Maxillofac Surg. 1990; 48: 1191-1195
- Surgical versus non-surgical treatment of fractures of the articular process of the mandible.J Craniomaxillofac Surg. 1992; 20: 345-347
- Condylar fractures: nonsurgical management.J Oral Maxillofac Surg. 1994; 52: 1185-1188
- Analysis of possible factors leading to problems after nonsurgical treatment of condylar fractures.J Oral Maxillofac Surg. 1994; 52: 793-799
- Long-term results of nonsurgical management of condylar fractures in children.Int J Oral Maxillofac Surg. 1999; 28: 429-440
- Simplified conservative treatment of facial fractures.Trans Int Conf Oral Surg. 1967; : 330-332
- Indications for conservative and surgical treatment of facial bone fractures.Panminerva Med. March 1969; 11: 88-90
- Mandibular fractures: a review of 156 consecutive cases.Laryngoscope. June 1997; 87: 957-961
- Facial fractures.in: David D.J. Simpson D.A. Craniomaxillofacial trauma. Churchill Livingstone, Edingburgh1995 ([chapter 11])
- Rowe N.L. Williams J.L. Maxillofacial injuries. vol. 1. Churchill Livingstone, 1985: 52
- Computer-based coding of fractures in the craniofacial region.Br J Plast Surg. 1989; 42: 17-26
- Facial fracture classification: current thoughts and applications.J Craniomaxillofac Trauma. 1999; 5: 31-36
- Changing patterns in the epidemiology and treatment of zygoma fractures: 10-year review.J Trauma. 1994; 37: 243-248
- Safety belt injury reduction related to crash severity and front seated position.J Trauma. 1987; 27: 733-740
- Reduction in road fatalities and injuries after legislation for compulsory wearing of seat belts: experience in Victoria and the rest of Australia.Br J Surg. 1979; 66: 518-521
- A comprehensive analysis of craniofacial trauma.J Trauma. 1994; 36: 34-47
- Craniomaxillofacial trauma in the elderly.J Oral Maxillofac Surg. 1995; 53: 1145-1149
- Athletic facial injuries.JAMA. 1984; 252: 3395-3398
- Fractures and refractures in intercollegiate athletes.Am J Sports Med. 1981; 6: 369
- Associated injuries in facial fractures: review of 839 patients.Br J Plast Surg. 1993; 46: 635-638
- Fractured zygomas.ANZ J Surg. 2003; 73: 49-54
- Morbidity of the infraorbital nerve following orbitozygomatic complex fractures.J Craniomaxillofac Surg. 1995; 23: 363-368
- The alterations in sensitivity of the infraorbital nerve following fractures of the zygomatico-maxillary complex.J Craniomaxillofac Surg. 1990; 18: 315-318
- Treatment of zygoma fractures.Oral Maxillofac Surg Clin North Am. 1990; 2: 155-169
- Fractures of the malar (zygomatic) bone.J R Coll Surg Edinb. 1977; 22: 187-196
Published online: November 20, 2006
Accepted: January 1, 2006
Received: June 24, 2005
☆Paper presented in part at:
- 1.ANZ Association of Oral and Maxillofacial Surgeons 20th Biennial Conference, Glenelg, Australia; 2003;
- 2.British Association of Plastic Surgeons, London, UK; 2003.
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.