Classical and modern principles and resources: their combination in the management of Le Fort fractures
Keywords:
lesions, bone fractures, internal fixation of fractures, fracture healing, high-cost technology, costs and cost analysis.Abstract
Introduction: Traumatic maxillofacial lesions are an important global health problem, as well as a public health burden.
Objective: Reflect on the need to combine classical and modern principles and resources in the management of Le Fort fractures in the Cuban context.
Main remarks: Treatment of facial fractures has evolved considerably through the years. Before the appearance of miniplates, stainless steel wire was used for osteosynthesis in maxillofacial surgery. Titanium osteosynthesis systems are currently the systems of choice in maxillofacial surgery. Despite their undeniable advantages, developing countries occasionally do not have all the equipment required for their use.
General considerations: Management of maxillofacial trauma is aimed at recovering the original form and function of the affected area. Without disregarding the theoretical principles of the management of Le Fort fractures, Cuban professionals should search for solutions in keeping with the resources available. The combination of classical techniques and modern resources, such as wired craniofacial suspensions, bar arches and maxillomandibular fixation screws, may be a reliable therapeutic alternative.
Downloads
References
Assiri ZA, Salma REG, Almajid EA, Alfadhel AK. Retrospective radiological evaluation to study the prevalence and pattern of maxillofacial fracture among Military personal at Prince Sultan Military Medical City [PSMMC], Riyadh: An institutional study. Saudi Dent J [Internet]. 2020 [access 20/05/21];32(5):242-9. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336016/
Rupani R, Singh M, Kumar V, Singh R, Kumar S, Yadav P. The maxillofacial injuries: A postmortem study. Natl J Maxillofac Surg [Internet]. 2018 [access 20/05/21];9(1):48-51. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996648/
Pietzka S, Kämmerer PW, Pietzka S, et al. Maxillofacial injuries in severely injured patients after road traffic accidents-a retrospective evaluation of the TraumaRegister DGU® 1993-2014. Clin Oral Investig [Internet]. 2020 [access 20/05/21];24(1):503-13. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223802/
Patil SG, Munnangi A, Joshi U, Thakur N, Allurkar S, Patil BS. Associated Injuries in Maxillofacial Trauma: A Study in a Tertiary Hospital in South India. J Maxillofac Oral Surg [internet]. 2018 [access 20/05/21];17(4):410-6. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181831/
Fazzalari A, Alfego D, Shortsleeve JT, Shi Q, Mathew J, Litwin D, Cahan M. Treatment of Facial Fractures at a Level 1 Trauma Center: Do Medicaid and Non-Medicaid Enrollees Receive the Same Care? J Surg Res [Internet]. 2020 [access 20/05/21];252:183-91. Available in https://pubmed.ncbi.nlm.nih.gov/32278973/
Al-Bokhamseen M, Salma R, Al-Bodbaij M. Patterns of maxillofacial fractures in Hofuf, Saudi Arabia: A 10-year retrospective case series. Saudi Dent J [Internet]. 2019 [access 20/05/21];31(1):129-36. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349956/
Yu BH, Han SM, Sun T, Guo Z, Cao L, Wu HZ, et al. Dynamic changes of facial skeletal fractures with time. Sci Rep [Internet]. 2020 [access 20/05/21];10(1):4001. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055228/
Juncar M, Tent PA, Juncar RI, Harangus A, Mircea R. An epidemiological analysis of maxillofacial fractures: a 10-year cross-sectional cohort retrospective study of 1007 patients. BMC Oral Health [Internet]. 2021 [access 20/05/21];21(1):128. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968332/
Xiao-Dong L, Qiu-Xu W, Wei-Xian L. Epidemiological pattern of maxillofacial fractures in northern China: A retrospective study of 829 cases. Medicine (Baltimore) [Internet]. 2020 [access 20/05/21];99(9):e19299. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478645/
Saperi BS, Ramli R, Ahmed Z, Muhd Nur A, Ibrahim MI, Rashdi MF, et al. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study. Clinicoecon Outcomes Res [Internet]. 2017 [access 20/05/21];9:107-13. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304986/
Phillips BJ, Turco LM. Le Fort Fractures: A Collective Review. Bull Emerg Trauma [Internet]. 2017 [access 20/05/21];5(4):221-30. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694594/
Kaur N, Kaur T, Kaur J, Kaur Y, Kapila S, Sandhu A. Efficacy of Titanium Mesh Osteosynthesis in Maxillofacial Fractures. J Maxillofac Oral Surg [Internet]. 2018 [access 20/05/21];17(4):417-24. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181864/
Gareb B, Roossien CC, van Bakelen NB, Verkerke GJ, Vissink A, Bos RRM, van Minnen B. Comparison of the mechanical properties of biodegradable and titanium osteosynthesis systems used in oral and maxillofacial surgery. Sci Rep [Internet]. 2020 [access 20/05/21];10(1):18143. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584639/
Elarabi MS, Bataineh AB. Changing pattern and etiology of maxillofacial fractures during the civil uprising in Western Libya. Med Oral Patol Oral Cir Bucal [Internet]. 2018 [access 20/05/21];23(2):e248-e255. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911362/
Sánchez Acuña JG, Canals González CJ. Traumatismos del macizo facial. En: Soler Vaillant R, Mederos Curbelo ON. Cirugía. Lesiones graves por traumatismo. La Habana: Ecimed; 2017.
Obimakinde OS, Ogundipe KO, Rabiu TB, Okoje VN. Maxillofacial fractures in a budding teaching hospital: a study of pattern of presentation and care. Pan Afr Med J [Internet]. 2017 [access 20/05/21];26:218. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491718/
Morales Navarro D. Fracturas mandibulares. En: Morales Navarro D. Fundamentos diagnósticos y terapéuticos del trauma maxilofacial. La Habana: Ecimed; 2021.
Published
How to Cite
Issue
Section
License
Authors retain all rights to their works, which they can reproduce and distribute as long as they cite the primary source of publication.
The Rev Cubana Estomatol is subject to the Creative Commons Attribution-Non-Commercial 4.0 International License (CC BY-NC 4.0) and follows the publication model of SciELO Publishing Schema (SciELO PS) for publication in XML format.
You are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.