Gunshot Injuries of the Maxillofacial Region

Abstract

The current principles and pillars in the management of gunshot maxillofacial injuries have largely been the result of an exhaustive experimental approach spanning centuries of warfare. However, while medical professionals endlessly strive to revolutionize healthcare in combat injury, there are simultaneous efforts directed towards creation of new and ever more lethal arms and ammunition. Consequently, these doctrines continue to undergo significant transformations with a contemporary understanding of war injuries as well as the advent of new surgical materials and modern instrumentation. Previously accepted principles like external pin fixations without adequate exposure of bony fragments, fracture stabilization using intra-osseous wiring and inter-maxillary fixation, minimal attention to primary soft tissue closure and delay in definitive management have been sidelined for most of the part. On the other hand, new principles have evolved that including adequate exposure of fracture fragments and precise anatomic rigid fixation, immediate bone grafting, definitive soft tissue management and early definitive repair allowing for better return of patients to their pre-traumatic appearance.