Pan facial fractures being the most complicated fracture as it involves multiple fractures of lower third of the face, the mid-face and the upper third, and so the management of such multiple fractures is extremely complicated. Proximity of the maxillofacial region with features or senses such as vision (diplopia), olfaction, respiration (airway), mastication (occlusion) or  chewing, deglutition and aesthetics; contributing in complexities of fracture management, also creates a dilemma for surgeon itself from operating point of view while keeping vitals in mind. The inaccessibility to the fractured site and its reduction is often iatrogenically left uncorrected leading to deformity.

The establishment of pattern of repairing the pan facial fracture is the most challenging and require great experience as well as knowledge, as it vary with each case. All the vertical and horizontal pillars has to be made to restore and rehabilitate the facial anatomy and aesthetic. After all the aggressive treatment, the residual deformity of facial trauma is not uncommon, which often require a second stage corrective surgery.

This article briefs about the management and simple approaches used to reduce and fix a case of pan facial trauma in a 23-year-old male who underwent a road traffic accident.⁽¹⁾

Keywords: Pan facial fracture, Upper third fracture, Mid face fracture, Nasal fracture, Open reduction and internal fixation.

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Dr Gaurang Thanvi

III Year Resident Department of Oral & Maxillofacial Surgery, MGDC Jaipur