Background: Post-traumatic secondary deformities of facial skeleton may occur due to non-management or ill management of primary injuries, whereas some unexpectedly occur even after dedicated management attempts. Orthognathic surgery (OGS) principles and techniques can be used as efficient tool to correct post-traumatic craniomaxillofacial deformities or skeletal developmental deformities during trauma management.
Aim and Objectives:
The aims of this study are to describe the different types of post-traumatic secondary deformity and address how to use the principles of orthognathic techniques to correct them.
Material and methods: Patients with orthognathic surgical osteotomies during primary or secondary management of facial trauma (referred to as trauma-OGS) during period of 2010 to 2018 were retrospectively reviewed. Variables pertaining to patients and surgery were collected that included trauma diagnosis, etiology, duration between trauma/primary surgery and secondary presentation, suggested reason for secondary deformity, intervention undertaken to address and the surgical outcome.
Results: 27 patients were eligible and extensively reviewed. Etiological categorization of Trauma-OGS could be done into post-traumatic deformities (18) and developmental deformities (9). Former group was further categorized as OGS done as primary procedure (8) that included immobile Le Fort fractures and delayed initial treatment as further categories, and OGS done as secondary procedure (10), that included complex fracturs and condylar fractures as further categories. The developmental deformities group was categorized into OGS done simultaneously during trauma management (5) or done as a secondary procedure after trauma management (4).
Conclusions: Application of principles and techniques of orthognathic surgery in indicated primary or secondary management of facial trauma patients should always be considered. The categorization of scenarios presented in this paper relating facial trauma and orthognathic surgery may further help to understand the application.