Chaudhry Aashish, Bhadani Shilpi, Pahari Kaushal Charan, Chawla Tanvi, Pandey Mani
Department of Orthopedics and Joint Replacement, Aakash Healthcare Super Speciality Hospital, Dwarka, Delhi, India.
Department of Plastic Surgery, Aakash Healthcare Super Speciality Hospital, Dwarka, Delhi, India.
Int J Surg Case Rep. 2025 Sep;134:111792. doi: 10.1016/j.ijscr.2025.111792. Epub 2025 Aug 12.
Severe facial trauma from firearm injuries poses significant reconstructive challenges. This case report highlights the use of advanced reconstructive techniques, including patient-specific 3D implants, radial forearm flaps, costochondral grafts, and prosthodontic rehabilitation, in the restoration of midfacial contour and function following a gunshot-induced deformity.
A 54-year-old male was admitted with a history of a gunshot injury sustained seven months ago to the left orbit and skull base causing severe facial deformities. Physical examination revealed a depressed midface, collapsed nasal bridge, scarred left upper eyelid, displaced right zygoma, missing left maxilla, and an oroantral communication on the right. A multi-staged reconstructive approach was used, including patient-specific 3D implants, a radial forearm flap, a costochondral graft, and prosthodontic rehabilitation, resulting in significant functional and aesthetic improvements.
This case demonstrates the successful integration of advanced surgical techniques to address severe trauma-induced deformities. Patient-specific 3D planning and implants restored facial contours, while the radial forearm flap provided vital soft tissue coverage. The costochondral graft reconstructed the missing maxilla, and prosthodontic rehabilitation restored oral function. This multi-disciplinary approach enabled the restoration of both form and function.
The combination of 3D implants, radial forearm flaps, costochondral grafts, and prosthodontic rehabilitation provides an effective, staged strategy for managing gunshot-induced facial deformities. This case emphasizes the importance of individualized, multi-staged approaches to achieve optimal outcomes in complex trauma. Further refinement of these techniques may improve future surgical protocols.
火器伤导致的严重面部创伤带来了重大的重建挑战。本病例报告强调了在修复枪伤所致畸形后的面中部轮廓和功能时，使用先进的重建技术，包括定制的3D植入物、桡侧前臂皮瓣、肋软骨移植和口腔修复。
一名54岁男性因七个月前左眼眼眶和颅底枪伤入院，导致严重面部畸形。体格检查发现面中部凹陷、鼻梁塌陷、左上眼睑瘢痕、右颧骨移位、左上颌骨缺失以及右侧口腔鼻窦相通。采用了多阶段重建方法，包括定制的3D植入物、桡侧前臂皮瓣、肋软骨移植和口腔修复，功能和美观均有显著改善。
本病例展示了成功整合先进手术技术以解决严重创伤所致畸形的过程。定制的3D规划和植入物恢复了面部轮廓，而桡侧前臂皮瓣提供了重要的软组织覆盖。肋软骨移植重建了缺失的上颌骨，口腔修复恢复了口腔功能。这种多学科方法实现了形态和功能的恢复。
3D植入物、桡侧前臂皮瓣、肋软骨移植和口腔修复的联合应用为处理枪伤所致面部畸形提供了一种有效的、分阶段策略。本病例强调了个体化、多阶段方法对于在复杂创伤中取得最佳结果的重要性。这些技术的进一步完善可能会改进未来的手术方案。
