Osteossíntese de fratura panfacial em paciente pediátrico: relato de caso

Abstract

Panfacial fractures are traumas that involve the zygomatico-orbital complex (ZOC), maxilla, and mandible. They are typically accompanied by naso-orbito-ethmoidal (NOE) fractures and frontal bone fractures, as well as disruption of the facial support pillars. These fractures are often associated with significant aesthetic and functional deformities, as well as ophthalmological and dental occlusion changes. Additionally, patients with this type of injury commonly experience systemic complications and require multidisciplinary treatment. The present study aims to document the osteosynthesis of a panfacial fracture in a pediatric polytrauma patient. The case involves a 7-year-old male patient who was a victim of a motorcycle accident. He presented with functional loss of the right eye and proptosis of the left eye, Le Fort III fractures on the right side and Le Fort II fractures on the left side, associated with fractures of the zygomatico-orbital complex (ZOC) and naso-orbito-ethmoidal complex (NOE) bilaterally. Additionally, fractures were identified on the right side of the mandible in the parasymphyseal region and in the condyle (greenstick fracture). Fractures of the alveolar processes of the maxilla and mandible with exposed bone, as well as avulsions of tooth germs and elements, were also noted. Soft tissue injuries were diffuse throughout the oral cavity. Furthermore, the patient had cranioencephalic trauma and fractures in the lower and upper limbs. Although functional outcomes were satisfactory, aesthetically, the contour of the face was only partially restored, and the patient’s nose remains saddle-shaped, indicating widening and depression of the midface. Therefore, surgeries and prosthetic rehabilitations aimed at correcting aesthetic relationships are still necessary.