Fracture of the vomero-premaxillary junction in a repaired bilateral cleft lip and palate patient.
Although dental trauma is common in bilateral cleft lip and palate (BCLP), patients' reports on bony fractures of the vomero-premaxillary junction cannot be found. The aim of this report is to illustrate clinical findings and the technique of fracture fixation in a child suffering from a fractured vomero-premaxillary junction as well as subsequent columella lengthening. A 4-year-old girl with a repaired BCLP presented with an open mucosal laceration and fractured vomero-premaxillary junction. Open reduction and fixation of the dislocated premaxilla was performed under general anesthesia. Fractured bone pieces of the vomero-premaxillary junction were removed and sharp bone edges at the vomer and the premaxilla were grinded. The repositioned premaxilla was fixed to the lateral alveolar arches with two mucoperiosteal sutures on each side. Additional columella lengthening was performed 2 years later. All family members were very happy about the new aesthetics of the girl. Although rare, fractures of the vomero-premaxillary junction present several challenges to clinicians related to anatomical, physiological, and psychological issues. Immediate and minimal invasive treatment strategies are recommended when managing such cases.
Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Roger Arthur
RA
Zwahlen
Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Yasas Shri Nalaka
YS
Jayaratne
Department of Oral and Maxillofacial Surgery, College of Oral Health Sciences, University of Technology, Kingston, Jamaica ; Facial Cleft Deformity Unit, University of Pretoria and Wilgers Hospital, Pretoria, South Africa.
Su Yin
SY
Htun
Facial Cleft Deformity Unit, University of Pretoria and Wilgers Hospital, Pretoria, South Africa.
Kurt-Wilhelm
KW
Bütow
bilateral cleft lip and palate; trauma; vomero-premaxillary junction