INJURIES OF THE HARD PALATE AND THE HORIZONTAL BUTTRESS OF THE MIDFACE

Traumatic injuries to the hard palate occurred in 20% of all Le Fort m idfacial fractures. The side of a palatal split was directly related t o the side that received the highest Le Fort injury. In a symmetric mi dfacial injury, the palate had a true midline split. Repair of palatal injuries from blunt trauma involved either wire and splinting (eight patients) or miniplate fixation without a splint (11 patients). There were fewer complications in those treated by the miniplate fixation te chnique (two of 11), as compared to those treated with wire and splint ing (four of eight). In miniplate fixation of midfacial fractures, att ention is focused on the reconstruction of the supporting buttresses o f the midface, both vertical and horizontal. In regard to the palate, this requires union of the inferior horizontal buttress. Gunshot wound s accounted for 21% of the patients and resulted in large bony disrupt ion of the palate, which required tree soft tissue and bone grafts for repair of the inferior horizontal buttress.