Incidence and management of major middle third facial fractures at the Royal Melbourne Hospital. A retrospective study.

In a retrospective study of 240 patients with major fractures of the middle third of the facial skeleton, the incidence, anatomical patterns, and management of these fractures have been reviewed, and an assessment made of the concomitant injuries to other organs. Most of the fractures occurred in the 20-29-year age group (39%), and over 83% of the patients in this study were males. The most common cause of injury was road accidents (80.8% of all cases), and automobile occupants represented most of this group. The Le Fort II fracture was the most commonly sustained, and there were several variations from the classical fracture patterns recorded, combinations of fractures at different levels being frequent. Ninety percent of patients had another concomitant injury, indicating the need for multi-disciplinary care of this type of patient. The most common treatment method involved the use of craniomaxillary and intermaxillary fixation, which was usually maintained for 22-28 days.