Rigid internal fixation of panfacial fractures without postoperative maxillomandibular fixation: A retrospective study of 25 cases

Abstract

The aim of this study was to retrospectively investigate the validity of rigid internal fixation of panfacial fractures (PFFs) without postoperative maxillomandibular fixation (MMF) in patients who underwent open reduction and internal fixation (ORIF). The medical records of patients with PFFs who underwent rigid internal fixation without postoperative MMF from April 2015 to November 2021 were retrospectively reviewed. The locations of PFFs were classified by the location affected. All patients except for 2 head-injured patients had regular follow-up examinations including postoperative imaging for over 6 months. There were 25 patients (15 males, 10 females; median age 51.3 years, range 16–89 years); median body mass index (BMI) 22.4 kg/m2, range 17.3–28.2 kg/m2). The most common location of PFFs was orbital bone (80%), with the exception of the maxilla. Mean operating time was 330 min, and mean blood loss was 120 ml. Postoperatively, one patient (4%) had malocclusion and mouth opening limitation, 5 patients (20%) required elastic traction for postoperative occlusal instability, and 2 patients (8%) had suture dehiscence. Three patients (12%) had postoperative soft tissue problems. Malocclusion or limited mouth opening was seen in one patient each (4%), and no patient exhibited facial asymmetry. The overall complication rate was 16%. The majority of patients (13/25) started oral feeding with a solid diet by postoperative day 3. In conclusion, proactively avoiding postoperative MMF for PFFs in which sufficient occlusal and bone stability can be achieved by rigid internal fixation not only avoids the disadvantages of postoperative MMF, but also provides satisfactory outcomes.

Keywords

• Panfacial fractures
• Maxillomandibular fixation
• Internal fixation