The reality of public service in the treatmente of panfacial fracture: Case Report




Traumas; Fractures; Facial bones; Oral surgery; Facial trauma; Le Fort; Jaw.


Objective of the present study is to present a clinical case of panfacial fracture with hybrid treatment through Rigid Internal Fixation and Semi Rigid Fixation of complex mandibular fracture. Female patient, 21 years old, feoderma, admitted to the ICU of Hospital Geral de Taipas after motorcycle accident, evaluated by the Buco Maxillofacial Surgery and Traumatology service in which she was diagnosed with panfacial fracture, with Le Fort I fractures, II, III, Lannelong, nasal fracture and complex mandibular fracture: right angle and left parasymphesis. The CT scan of the face confirmed the presence of Panfacial fracture. A tracheostomy surgical procedure was performed, plus the installation of an upper and lower Erich bar with closed reduction of the mandibular fracture with maxillary mandibular block with an elastic band in the first surgical period. After stabilization of the clinical picture, fixation of the mandibular fracture was performed through the accesses, submandibular and submental with FIR of the fracture of the right mandibular angle and Semi Rigid Fixation of the left parasymphysis fracture and mandibular maxillary block with elastic. The patient was transferred from the UTI to the ward where she was discharged from the hospital with satisfactory facial symmetry, Eagle Class I dental occlusion, preserved mandibular movements and complete absence after 7 months of signs and symptoms of paresthesia and neuropraxia of cranial nerves V and VII.


Ali, K., Lettieri, S.C. (2017). Management of Panfacial Fracture. Semin Plast Surg, 31(2),108-117.

Banerjee, P. K., Jain, A., Behera, B. (2016). Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience. Indian J Anaesth, 60(1), 573-577.

Cascone, P., Spallaccia, F., Graziana, M. A.F., Rivaroli, A., Saltalrel, A., Iannetti, G. (2008). Rigid versus semirigid fixation for condylar fracture: experience with the external fixation system. J Oral Maxillofac Surg, 66(2), 265-271.

Chaydhry, O., Isakson, M., Franklin A., Maqusi, S., El Amm, C. (2015). Facial Fractures: Pearls and Saikrishna Degala, S. Shyam Sundar, K. S. Mamata. A Comparative Prospective Study of Two Different Treatment Sequences i.e. Bottom Up–Inside Out and Topdown–Outside in, in the Treatment of Panfacial Fractures. J Maxillofac Oral Surg, 14(4), 986-994.

Choi, J. W., Kim, M. J. (2019). Treatment of Panfacial Fractures and Three-Dimensional Outcome Analysis: The Occlusion First Approach. J Craniofac Surg, 30(4), 1255-1258.

Clauser, L., Galiè, M., Mandrioli, S., Sarti, E. (2003). Severe panfacial fracture with facial explosion: integrated and multistaged reconstructive procedures. J Craniofac Surg, 14(6):893-988.

Degala, S., Sundar, S.S., Mamata, K.S. (2015). A Comparative Prospective Study of Two Different Treatment Sequences i.e. Bottom Up-Inside Out and Topdown-Outside in, in the Treatment of Panfacial Fractures. J Maxillofac Oral Surg, 14(4), 986-994.

Ellis, E., Dechow, P.C., Carlson, D.S. (1988). A comparison of stimulated bite force after mandibular advancement using rigid and nonrigid fixation. J. oral maxillofac. Surg, Philadelphia. 46(1), 26-32.

Ellis, E. (1991). The internal fixation of fractures: Historical perspectives. In: TUCKER, M.R., et al. Rigid Fixation for Maxillofacial Surgery. Philadelphia: l B. Lippincot, Parte I, cap.I, 3-29.

Filho, J., França, S., Araújo, L., Pereira, J., Belchior, I., & Sampieri, M. (2018). Intervenção cirúrgica de um canino incluso em sínfise mandibular: relato de caso. Revista Da Faculdade De Odontologia - UPF, 23(3), 329-332.

Follmar, K. E., Debruijn, M., Baccarani, A., Bruno, A. D., Mukundan, S., Erdmann, D., Marcus, J.R. (2007). Concomitant injuries in patients with panfacial fractures. J Trauma, 63(4), 831-835.

Guerrissi, J. O. (2016). Treatment Options in Maxillofacial Fractures. J Craniofac Surg, 27(5), 445-447.

Hashemi, H. M., Parhiz, A. (2011). Complications using intermaxillary fixation screws. J Oral Maxillofac 577 Revista da Universidade Vale do Rio Verde, Três Corações.10(1), 570-578.

Jang, S. B., Choi, S. Y., Kwon, T. G., Kim, J. W. (2020). Concomitant injuries and complications according to categories of pan-facial fracture: a retrospective study. J Craniomaxillofac Surg, 48(4),427-434.

Kumar, K.A., Kumar, B. P., Mohan, A. P., Masram, A. K., Tyro, D., Gandla, D. (2015). Assessment of the Efficacy of Submental Intubation in the Management of Midfacial and Panfacial Trauma Patients. J Maxillofac Oral Surg. 14(3), 674-81.

Kim, J., Choi, J. H., Chung, Y. K., Kim, S. W. (2016). Panfacial Bone Fracture and Medial to Lateral Approach. Arch Craniofac Surg, 17(4). 181-185.

Koraitim, M. (2020). Panfacial Fractures Management. J Craniofac Surg, 31(4), 329-331.

Leach, J., Truelson, J. (1995). Traditional Methods vs Rigid Internal Fixation of Mandible Fractures. Arch Otolaryngol Head Neck Surg, 121(7), 750–753.

Mansher, S., Joseph, A., Ricci, E. J. C. (2015). Use of Intraoperative Computed Tomography for Revisional Procedures in Patients with Complex Maxillofacial Trauma. Plast Reconstr Surg Glob Open, (3), 463.

Mendes, R. B., Dultra, J. D. A., Dultra, F. K. A., Maciel, A. D. S., Toledo, Í. C., Azevedo, R. A. (2011). Evaluation of conservative treatment of mandibular fracture. Int J Oral Maxillofac Surg, 40(10),1113.

Ramakrishnan, k., Palanivel, I., Narayanan, V., Chandran, S., (2020). Narayanan, J. Sequencing of Fixation in Panfacial Fracture: A Systematic Review. J Maxillofac Oral Surg, 20(2), 180-188.

Singaram, M., Ganesan, I., Kannan, R., Kumar, R. (2016). Avaliação da segurança e utilidade da intubação submentoniana na cirurgia de trauma panfacial. J Korean Assoc Oral Maxillofac Surg, 42(2), 99-104.

Sharma, S, Dhanasekaran, V. (2015). Surgical Approaches and Management of Panfacial Trauma: A Case Report. J Clin Diagn Res, 9(8), 13–14.

Yun, S., Na, Y. (2018). Panfacial bone fracture: cephalic to caudal. Arch Craniofac Surg, 19(1), 1-2.



How to Cite

MARTINS, L.; FONSECA , J. D. S. da .; GROSS, D. J.; FERNANDES DE CASTRO, M.; PIMENTEL, A. C. .; SENDYK, W. .; MARÃO, H. F. The reality of public service in the treatmente of panfacial fracture: Case Report. Research, Society and Development, [S. l.], v. 10, n. 9, p. e34510916320, 2021. DOI: 10.33448/rsd-v10i9.16320. Disponível em: Acesso em: 23 sep. 2021.



Health Sciences