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Abstract
Treatment of missile wounds of the maxillofacial regions consists of three major phases:
primary, intermediate, and reconstructive. Missile wounds cause severe local trauma.
The physiologic limits of the tissue to repair may be exceeded by the additional trauma
of an open procedure; open procedures are consequently more likely to fail than are
closed procedures. The basic tenet of union is strict immobilization for an adequate
length of time. It is not uncommon for immobilization to take many months. Fractures
within the tooth-bearing portion of the arch can be treated successfully by conventional
intermaxillary fixation. Compound, comminuted fractures distal to the remaining teeth
require supplemental devices to counteract the upward and medial pull of the muscles
of mastication upon the proximal fragment. Intraoral acrylic splints in conjunction
with intermaxillary fixation have frequently been used with success to stabilize the
fragments. The additional support of external appliances has been required in some
cases.
Reconstruction must await maturation of soft tissue. Reconstructive procedures may
require the coordination of several disciplines and may include grafting of bony and/or
soft tissue, vestibuloplasty, and prosthetic rehabilitation.
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References
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Article info
Footnotes
☆The opinions contained herein are the private ones of the writers and are not to be construed as official or reflecting the views of the Navy Department or the naval service at large, or the Department of the Air Force or the Air Force Medical Service at large.
Identification
Copyright
© 1969 Published by Elsevier Inc.
