Case Report: Facial Trauma: Not a Stigma in a Newer Single Stage Reconstructive Surgery

Abstract

In trauma surgery, instead of discarding the fractured bone segments as done in earlier days in patients with depressed skull fractures, these fragments can be used to reconstruct the damaged facial architecture.The aim of the study was to test the feasibility of managing comminuted frontal bone depressed fracture by a single stage debridement, reduction and replacement of the bone fragments and soft tissue reconstruction. bone cranioplasty using the native fractured bones was prospectively done in 11 patients over a period of one year from January 2011 to December 2012. We report on our clinical cases and the surgical technique of managing comminuted frontal bone fractures. The posttraumatic frontal bone defect was caused by road traffic accident. There were no deaths due to the minimal complications from the procedure. Two patients (18%) had mild scalp infections, 1 patient (0.9%) had epileptic seizure, which was controlled by medication. It thus concluded that the fractured frontal bone can be reconstructed immediately with debridement in spite of major sinus involvement and underlying brain and dural damage. Factors contributing to success are removal of foreign debris from the fractured bone segments, perfect dural repair with the use of pericranial flaps and bone cover being provided from beneath by the pericranial flap and above the skin. These segments heal excellently with bone remodeling.

Keywords: Frontal bone fracture, Reconstruction, Single stage reconstruction