Current concepts in midface fracture management.

PURPOSE OF REVIEW: Management of midface trauma is complex and challenging and requires a clear understanding of the facial buttress system, subunit anatomy and inter-relationships. Too often clinicians attempt surgical repair without adequate knowledge of the common complications associated with poor reduction and improper sequencing of fracture repair. This review outlines a working approach to the identification and management of such injuries, and the definitive management of common injury patterns.

RECENT FINDINGS: Midface trauma, with or without life-threatening and sight-threatening complications, may arise following isolated injury, or be associated with significant injuries elsewhere. Assessment needs to be both systematic and repeated, with the establishment of clearly stated priorities in overall care.

SUMMARY: Accurate and precise relocation of bony subunits and resuspension of soft tissues is vital in achieving acceptable functional and aesthetic outcomes.