Craniofacial Trauma Case Study MXCSCraniofacial J6819B

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Craniofacial Trauma. Resorbable

and titanium plating application.

Case Study

Patient Profile

A 36-year-old male was involved in a motorcycle accident.

Patient suffered basilar skull fracture, multiple facial

fractures, head injuries and soft tissue injuries of the

cervical spine. Patient was not wearing a helmet at the

time of the accident.

Treatment

Patient was treated with closed reduction of a right condyle

fracture and nasal bone fractures. Arch bars were adapted

to the maxillary and mandibular arches and secured with

stainless steel wire. The mandible was then brought into

occlusion and wired. The nasal bones were then molded

into midline alignment, and a stent was placed over the top.

One week later an open reduction and internal fixation of

the right orbital floor blowout and right zygoma/malar

fracture was performed. A 2.1 mm taper Fisher burr was

used to make a hole in the thickest portion of the malar

buttress. The zygoma was manipulated until the fracture was

anatomically reduced. A 1.5 mm Synthes orbital rim plate

was placed across the zygomatico-frontal suture. A 2.0 mm

plate was placed across the zygomatic buttress. A 2.0 mm

4-hole plate was placed on the piriform rim. With the

zygoma secured, attention was given to the orbital floor.

A 1.5 mm Resorbable Contourable Mesh Plate (50 mm x

50 mm, 0.5 mm thick) was heated in the hot water bath,

contoured over the thin comminuted orbital floor, and

secured with one 1.5 mm screw. The resorbable mesh

provided contourability and adequate support for the globe.

Prior to closing, a forced duction test was performed on the

inferior rectus muscle. It was noted that the patient had full

range of motion of the right globe.

Synthes CMF Craniofacial Trauma

Craniofacial Trauma

Preoperative radiograph

Immediate postoperative radiograph

Immediate postoperative radiograph

Postoperative Management

Patient was kept in IMF for two weeks due to the mandible

fracture, then progressed to elastics and physical therapy.

Approximately 3 months postoperative the patient

experienced conductive hearing loss. A CT of the temporal

bones was performed. A fracture of the left temporal bone

appears to extend through the middle ear. The fracture line

is considerably less distinct than seen on the immediate

postoperative scan. No obvious consequence is noted to

explain the patient’s conductive hearing loss.

Synthes CMF

3-month postoperative radiograph

3-month postoperative radiograph

Results from case studies are not predictive of results in other cases.

Results in other cases may vary.

Craniofacial Trauma

Materials Used

Metal

– 1.5 mm Orbital Rim Plate

– 2.0 mm Tension Band Plate

– 2.0 mm Curved Broad Plate

– 1.5 mm and 2.0 mm Titanium Screws

Surgeon profile

Jeffrey Wheaton, DDS, MD

St. Vincent’s Hospital

Santa Fe, New Mexico

Synthes CMF

1302 Wrights Lane East

West Chester, PA 19380

Telephone: (610) 719-5000

To order: (800) 523-0322

Fax: (610) 251-9056

Synthes (Canada) Ltd.

2566 Meadowpine Boulevard

Mississauga, Ontario L5N 6P9

Telephone: (905) 567-0440

To order: (800) 668-1119

Fax: (905) 567-3185

© 2006 Synthes, Inc. or its affiliates. All rights reserved. Synthes is a trademark of Synthes, Inc. or its affiliates. Printed in U.S.A. 6/07 J6819-B

www.synthes.com

Biomaterials

– 1.5 mm Resorbable Contourable

Mesh

– 1.5 mm Resorbable Cortex Screw