The Role of Primary Bone Grafting in Complex Craniomaxillofacial Trauma

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Abstract
The role of craniofacial surgical techniques and immediate bone grafting in the management of complex craniofacial trauma was reviewed. Patients (401) with complex facial injuries were treated. Primary bone and cartilage grafts (241) were performed in 66 patients. Complex facial injuries should be managed by direct exposure, reduction, and fixation of all fractures utilizing interfragmentary wiring. Very comminuted or absent bone is replaced by immediate bone grafting, producing a stable skeleton without the need for external fixation devices. Associated mandibular fractures are managed with rigid internal fixation utilizing A-O technique. Results of immediate bone grafting were excellent, and complications are rare. All deformities should be corrected, whenever possible, during the initial operation. This 1-stage reconstruction of even the most complex facial injuries will prevent severe postoperative traumatic deformity and disability that may be extremely difficult or impossible to correct secondarily.

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