title: Concomitant injuries in patients with panfacial fractures.
abstract: BACKGROUND
  Patients with panfacial fractures comprise a small portion of the overall facial fracture patient population. Because of the forces necessary to cause panfacial injury, these patients often have other concomitant injuries. The timing of operative facial fracture management remains controversial.
  
  
  METHODS
  A 3-year review of all patients with facial fractures was conducted at Duke University Medical Center (2003-2005, 437 total patients). All patients with panfacial fractures, defined as fractures involving at least three of the four facial segments (frontal, upper midface, lower midface, and mandible), were analyzed.
  
  
  RESULTS
  Panfacial fractures were present in 38 patients (9% of overall facial fracture population). Twenty (53%) of these patients suffered concomitant injuries. The most common mechanism of trauma was motor vehicle collision, and the most common category of concomitant injury was intracranial injury or hemorrhage. Other commonly occurring categories of injury included abdominal organ injury, pneumothorax, pulmonary contusion, spine fracture, rib or sternum fracture, extremity fracture, and pelvic fractures. There was no significant difference in day of operation for the management of facial fractures between those with isolated facial injuries and those with other concomitant injuries (hospital day 2.1 vs. hospital day 2.9, not significant).
  
  
  CONCLUSIONS
  Concomitant injuries to all parts of the body are found in patients with panfacial trauma. In our experience, these injuries do not significantly delay or have an adverse effect on the treatment of facial fractures. A treatment strategy for consistent timely management of facial fractures is described.
authors: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors: Keith E
authors: KE
authors: Follmar
authors: Marklieke
authors: M
authors: Debruijn
authors: Alessio
authors: A
authors: Baccarani
authors: Anthony D
authors: AD
authors: Bruno
authors: Srinivasan
authors: S
authors: Mukundan
authors: Detlev
authors: D
authors: Erdmann
authors: Jeffrey R
authors: JR
authors: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D015897:Comorbidity; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery