Comprehensive management of pan-facial fractures.

In the last 20 years, the management of pan-facial injuries has progressed to the point where immediate treatment using open reduction with rigid fixation is now the standard of care. After discussing the historical progression of treatments, the authors present a plan for treatment of craniofacial injuries based on the use of incisions that expose the four areas of the face: the frontal area, upper midface, lower midface and occlusion, and the basal mandibular area. According to the authors, five incisions permit access to the entire anterior craniofacial skeleton: the coronal, lower eyelid, upper and lower gingival-buccal-sulcus, and the preauricular-retromandibular. Through these incisions, the facial buttresses can be accessed to allow reduction and rigid fixation of facial fractures.