Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following high-velocity facial trauma. Reports midface pain, malocclusion, and epistaxis. Clinical assessment reveals mobility of the maxilla and nasal complex upon manipulation. Denies vision changes or loss of consciousness.
Clinical Examination Findings
Facial examination reveals bilateral periorbital ecchymosis, subconjunctival hemorrhage, and midface edema. Palpation demonstrates step-off deformities at the infraorbital rims and nasofrontal suture. Intraoral exam confirms maxillary mobility (pyramidal fracture pattern) and anterior open bite malocclusion.
Treatment Protocol
Immediate airway stabilization and cervical spine precautions initiated. Surgical management involves Open Reduction and Internal Fixation (ORIF) of the nasofrontal, infraorbital, and zygomaticomaxillary buttresses using titanium plating system. Post-operative antibiotics and maxillomandibular fixation (MMF) as indicated.