Surgical Management of Maxillofacial Trauma: Open Reduction and Internal Fixation with Intermaxillary Fixation Techniques and Outcomes

This book chapter presents a case report and discussion on the use of open reduction and internal fixation (ORIF) with intermaxillary fixation (IMF) in the management of posttraumatic maxillofacial fractures. The chapter includes a detailed case presentation, operative procedure, and a comprehensive discussion of the surgical technique, advantages, limitations, and postoperative care associated with ORIF with IMF.

The case presentation describes a patient who sustained facial injuries in a road traffic accident, resulting in a Le Fort I maxillary fracture and a fracture of the right nasal bone. The diagnosis was confirmed through computed tomography with 3-D reconstruction. The surgical intervention involved ORIF with IMF, with an upper gingivobuccal sulcus incision used to access the fracture site. The maxillary alveolus was stabilized in class I occlusion using IMF, followed by the application of 3-D titanium miniplates for fixation. The postoperative period was uneventful, with satisfactory results observed during follow-up examinations.

The discussion section introduces ORIF with IMF as a commonly employed surgical procedure in the management of maxillofacial fractures. The surgical technique involves precise repositioning of fractured bone segments, internal fixation using various methods, and the use of intermaxillary fixation to stabilize the jaw. The advantages of ORIF with IMF, including precise fracture reduction, stable fixation, restoration of occlusion, and improved long-term outcomes, are discussed. The limitations, such as the requirement for surgical skill and experience, the need for an individualized approach, and potential complications, are also addressed.

In conclusion, this book chapter provides valuable insights into the use of ORIF with IMF for the management of posttraumatic maxillofacial fractures. Through a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy, considerations, and postoperative care associated with this surgical technique. This information can guide surgeons in making informed decisions and achieving successful outcomes in the treatment of maxillofacial fractures using ORIF with IMF.