Experience of the treatment of combat injuries of the maxillofacial area with titanium implants in the conditions of modern war

Abstract

The aim. To research some features of a combat injury of the jaw-facial region and possible options of surgical treatment using titanium implants. Materials and methods. We investigated clinical cases of the treatment of high-speed combat injuries of the maxillofacial area in the department of maxillofacial surgery with otolaryngological beds of Municipal Non-Commercial Enterprise “City Hospital of Emergency and Urgent Medical Care of the Zaporizhzhia City Council”. Results. Postoperative follow-up of the patients affected by high-velocity projectile showed positive treatment outcomes in all observations. The negative consequences of the trauma revealed in the postoperative period were persistent paralysis of facial muscles, lower jaw dysfunction with limited mouth opening, necrosis of the damaged tissues of the oral cavity, necrosis and suppuration of tissues around the wounds, formation of deforming scars and fistulas, sequestration. The most common functional disorders as a result of injury were paralysis of the facial muscles and mandibular dysfunction which were observed in 100 % of our cases. Sequestration of the bone fragments was observed in only one case, only one patient showed all the above mentioned negative pathological consequences of high-speed trauma. Conclusions. Our experience in the treatment of high-velocity gunshot wounds at the face leads to the conclusion that the results of the treatment and the choice of surgical tactics depend primarily on the severity of the wound and the degree of destruction of soft and bone tissues of the face. The great variety of the nature of injuries does not allow determining of a “golden standard” for final surgical treatment.

Keywords

• face
• trauma
• military
• fracture
• tracheostomy