Rigid facial skeletal fixation: advances in treatment.

Rigid facial skeletal fixation with miniplates, combined with craniofacial reconstruction techniques, has dramatically changed the treatment of facial fractures. Our use of these newer techniques in 142 facial fractures treated during the past 14 months has resulted in improved aesthetics and function, with a low complication rate. Advances over other techniques include (1) craniofacial incisions with wide subperiosteal exposure, (2) rigid skeletal fixation that virtually eliminates the need for continued intermaxillary fixation, suspension wires, or tracheostomy, (3) primary bone grafting with cranial bone, and (4) early definitive treatment. These innovative techniques establish a higher standard of care for facial fractures, as illustrated by the three cases we review.