Craniofacial traumas: Immediate and delayed treatment

In 1998, 28 patients with craniofacial fractures have been under observatio n at the Emergency Room of the Policlinico Umberto I of Rome. Twenty-six pa tients have undergone reduction and contention surgery of the fractures. Th e diagnosis of the fractures has been achieved through CT axial scanning an d coronal reconstruction as well as with three-dimensional CT. The CT spira l was used in those cases that required more rapid intervention, whereas th e MRI was used to evaluate the condition of the eyeball. Twenty of such pat ients underwent surgical treatment a few hours after the trauma and, in suc h eases, excellent aesthetic and functional results were achieved. The gene ral and neurological conditions of six patients did not permit prematurely proceeding with surgery. Two patients died a few hours after the trauma of the injuries sustained. Of the six patients who underwent delayed treatment , acceptable functional and aesthetic results were achieved in four, wherea s the remaining two patients had inadequate results. The results we have ob tained show that it is possible to achieve the best results, both aesthetic and functional, through immediate treatment. Delayed treatment is carried out at least 2 weeks after the trauma because of the patient's condition an d presents reconstruction difficulties that do not guarantee a satisfactory aesthetic reconstruction as well as, in some cases, an effective functiona l restoration.