MANAGEMENT OF MULTIPLE MAXILLOFACIAL FRACTURE WITH MILD HEAD INJURY

Abstract

Introduction: Maxillofacial fracture is an injury that is often followed by head injury. Maxillofacial fractures vary in their severity, some involves either a single bone or several complex bones, depending on the force degree of impact on the face region. A comprehensive management can prevent more severe complications of head injury. This case report describes the management of multiple maxillofacial fractures with head injury.

Case report: A 26-year-old female patient came to the Emergency Department of RSUP Dr. Hasan Sadikin Bandung with complaints of fractures in the facial bones and headaches due to an accident. Physical examination revealed facial asymmetry, edema, and hematomas in the bilateral periorbita, right and left mandible, and mental region. The patient had performed a CT scan of the head before and it appeared that there was a soft tissue swelling in the left temporal region, as well as bone discontinuities in the left zygoma and left mandibular angle with sulcus and gyrus, sylvian fissure, uncompressed ventricles and cisterns and no midline shift. The patient underwent definitive treatment with open reduction intermaxillary fixation (ORIF) for multiple maxillofacial fractures and conservative treatment for her head injury.

Conclusion: The success of maxillofacial fracture treatment with head injury is strongly determined by accuracy in the initial assessment and comprehensive treatment involving multidisciplinary. Head injuries need priority treatment followed by treatment of maxillofacial fractures.

Keywords: Multiple maxillofacial fractures, Head injury, Open reduction (ORIF), Close reduction