Facial fractures from blunt object injury treated at Siriraj Hospital.

There were 1,819 cases of facial fracture from blunt object injury treated by the Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, during the period January 1, 1983 to December 31, 1988. The male-to-female ratio was 3.5:1. The ages of the patients ranged from 2 to 93 years, with the most frequent range encountered being between 21 and 30 years (44.5%). The most common was traffic accidents (54.1%), followed by physical assault, sports, occupational and self-inflicted injury among others. There were 1,749 new cases and 70 cases referred by other hospitals. The facial fractures were classified into five groups: 1. Nasal fracture (30.0%), 2. Mandibular fracture (26.5%), 3. Zygomatic fracture (24.2%), 4. Maxillary fracture (15.7%), 5. Frontal fracture (3.6%).

Comparative study on unilateral craniomaxillary suspension and bilateral craniomaxillary suspension.

One hundred and thirty-two patients who sustained Le Fort fracture were grouped into two. The patients in one group were reduced in usual manner with craniomaxillary suspension on both sides of the jaw; the another group were also reduced in just the same usual manner, except craniomaxillary suspension was done on only one side of the jaw. The result obtained from twelve postoperative weeks follow up show no difference on both groups.

Treatment of subcondylar fracture of the mandible.

Forty eight patients with subcondylar fracture of the mandible were study prospectively. 42 patients were treated by non-reductive method and 6 patients were treated by open reduction and internal fixation method. The patients were followed up for about one to three years duration. AII of the patients treated by open reduction showed good alignment and good function. The patients treated by non-reductive method showed poorer alignment : nine cases could not protease normally. AII of the patients which could not profuse normally had been immobilized by intermaxillary fixation procedure. This study shows that non-reductive treatment without intermaxillary fixation can by used to treat the patients as a standard method.

Mechanism of fracture of the mandible.

One hundred and forty six patients with mandibular fracture were studied. The result revealed that single fracture = 60.95% double fracture = 36.30% and Triple fracture = 2.75%. The teeth bearing part were fractured much more than the vertical part, multiple fracture of the mandible may be double fracture or triple fracture. Road Traffic accident is the most common cause of mandibular fracture. The mechanism of fracture was discussed in detail.

The effect of intermaxillary fixation on the patients’ nutrition.

The effect of intermaxillary fixation on patients’ nutritional status was studied by observing weight reduction after the procedure. From 1985 to May 1986, fifty jaw-fractured patients were treated by this method and have complete body weight records. The average weight of the patients before fixation was 49.99 kgs. 1, 2, 3, and 4 weeks after the operation, weight changed to 49.03, 48.82, 48.67 and 48.68 kgs respectively, and there was no statistical significance (P = 0.05).