Fronto-naso-orbital trauma.

The management of fronto-naso-orbital trauma utilizing the principles of craniofacial surgery should produce optimal results in one operation. The surgeon should aim for the complete correction of all deformities whenever possible during the initial operation, regardless of the time taken. Care must be taken to expose all fracture sites and directly visualize fracture patterns and degree of displacement. Only then can a plan of correction be formulated. Direct wiring of fracture sites and fragments in combination with primary bone grafts to replace severely damaged or missing bone segments and contour bony deficits will then produce a completely stable skeleton without the need for external fixation devices. The management of trauma to the fronto-naso-orbital region is a great challenge even for the most skilled surgeon. Failure to recognize and treat these injuries adequately will result in severe post-traumatic deformities and disabilities, many of which may be extremely difficult or impossible to treat adequately. Adherence to the principles and techniques elucidated in this article will facilitate the care of these difficult problems.