Table Of ContentMaxillofacial
Trauma
A Clinical Guide
Akhilesh Kumar Singh
Naresh Kumar Sharma
Editors
123
Maxillofacial Trauma
Akhilesh Kumar Singh
Naresh Kumar Sharma
Editors
Maxillofacial Trauma
A Clinical Guide
Editors
Akhilesh Kumar Singh Naresh Kumar Sharma
Banaras Hindu University Banaras Hindu University
Varanasi Varanasi
India India
ISBN 978-981-33-6337-3 ISBN 978-981-33-6338-0 (eBook)
https://doi.org/10.1007/978-981-33-6338-0
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Singapore Pte Ltd. 2021
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This book is dedicated to our beloved parents and family
members for their love and support our respected teachers
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opportunity to serve.
Foreword
It is my privilege to write a foreword for this book entitled “Maxillofacial
Trauma: A Clinical Guide” having 24 chapters on different aspects of maxil-
lofacial trauma including basic as well as clinical topics.
In the last two decades, there have been tremendous advancements in the
management of maxillofacial trauma and facial injuries. The approach and
treatment scenario in the field of maxillofacial trauma is changing very fast.
This book covers each and every aspect of maxillofacial trauma which
includes diagnostic approach, treatment planning, patient concerns, and
recent advancements.
I wish all the best to the authors of this book and recommend this to all
readers and wish that they all will be benefitted.
Shadab Mohammad
Awarded Padmashree from Government of India (2019)
Department of Oral and Maxillofacial Surgery
Faculty of Dental Sciences
King George’s Medical University
Lucknow, UP, India
vii
Preface
The book entitled “Maxillofacial Trauma: A Clinical Guide” has been
designed in such a way that it amalgamates the basic concepts in understand-
ing the science of maxillofacial skeleton as well as the clinical skills required
in managing the complex facial fractures. The book has two sections: First
one deals with the introduction of maxillofacial trauma, biomechanics of
maxillofacial skeleton, principles of osteosynthesis and internal fixation,
medicolegal aspects of maxillofacial trauma, and preoperative workup which
provides a brief outline of basic concepts in understanding the anatomy and
physiology of facial skeleton. The other section is oriented clinically with
case-based discussion that starts from the emergency management of facial
trauma including the recent protocols of basic life support and advanced
trauma life support, emergency airway management followed by definitive
management guidelines in stabilizing and fixing the fractured facial bones.
The clinical cases have been discussed in a way to provide practical knowl-
edge and skills to the postgraduate students and clinicians which will enhance
their knowledge and facilitate the decision-making process.
Previously, students had to go through various textbooks to procure the
information regarding anatomy, physiology, biomechanics, anesthetic per-
spectives, clinical protocol required but this one book will provide all neces-
sary details in one place. We have also included the current evidences and
existing controversies in deciding treatment of complex clinical conditions
like panfacial trauma and condylar fractures. The chapters include various
clinical pictures, schematic diagram, classifications, flow chart including
treatment algorithms which will make the subject easy to understand.
This book is a collaborative effort of contributors from premier institutions
of the country which makes it unique. We express our sincere gratitude to all
the authors for their valuable contribution.
We acknowledge our editing team members Dr Madan Mishra, Dr Richik
Tripathi, Dr Arun Pandey, and Dr Janani Anand Kumar for their valuable
inputs. We are also thankful to Mr Rajesh Kumar, Mr Chandan Kumar, and
Mr Lalit Vishwakarma, our photography and art team, for their tremendous
efforts.
We also wish to thank Mr. Gaurav Singh and Mr Ejaz Ahmad from
Springer Nature for their valuable support.
Varanasi, India Akhilesh Kumar Singh
Varanasi, India Naresh Kumar Sharma
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Contents
Part I Basic Considerations
1 Introduction to Craniomaxillofacial Trauma . . . . . . . . . . . . . . . . 3
Akhilesh Kumar Singh and Janani Anand Kumar
2 Surgical Anatomy of the Face . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Atul Kusanale
3 Biomechanics of the Maxillofacial Skeleton . . . . . . . . . . . . . . . . . 21
Kuldeep Vishwakarma and Bharat Shukla
4 Principles of Osteosynthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Arun Pandey and Janani Anand Kumar
5 Basic Introduction to Internal Fixation Devices and
Armamentarium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Richik Tripathi and Shweta
6 Medicolegal Aspects in Maxillofacial Trauma . . . . . . . . . . . . . . . 87
George Paul, Parveen Sharma, and Rishi Kumar Bali
7 Perioperative and Anesthetic Considerations
in Maxillofacial Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Sandeep Sahu, Nimisha Verma, and Dhruv Jain
Part II C ase Based Discussion
8 Emergency Management of Trauma Patient
and General Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Madan Mishra, Samir Misra, and Abhivyakti Tewari
9 Soft Tissue Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Vibha Singh, Deepika Jain, and Shanthosh Kanna
10 Dentoalveolar Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Amiya Agrawal and Arunesh Kumar Tiwari
11 Introduction to Mandibular Fractures . . . . . . . . . . . . . . . . . . . . . 177
Akhilesh Kumar Singh, Dipti Samal, and Abhishek Singh
12 Symphysis, Parasymphysis and Body Fractures . . . . . . . . . . . . . 191
Sailesh Kumar Mukul and Abhishek Singh
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xii Contents
13 Angle and Ramus Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Uma Shanker Pal and Roop Ganguly
14 Condylar Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Vidya Rattan
15 Introduction to Midface Fractures . . . . . . . . . . . . . . . . . . . . . . . . 251
Naresh Kumar Sharma, Arun Pandey, and Nitesh Mishra
16 Le Fort Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Naresh Kumar Sharma and Nitesh Mishra
17 Zygomaticomaxillary Complex Fractures . . . . . . . . . . . . . . . . . . 293
Virendra Singh, Nitesh Chhikara, and Neha Jajodia
18 Naso-Orbito-Ethmoidal Complex Fractures . . . . . . . . . . . . . . . . 311
Sachin Rai
19 Orbital Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Venkatesh Anehosur and Anandhi Visweswaran
20 Frontal Sinus Wall Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Sujata Mohanty
21 Panfacial Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Abhay Datarkar and Amit Bhawalkar
22 Animal Bite, Firearm and Ballistic Injuries . . . . . . . . . . . . . . . . . 387
Indu Bhusan Kar, Rosalin Kar, Alok Kumar Sethi,
and Prashant D. Chopda
23 Complications in Maxillofacial Trauma . . . . . . . . . . . . . . . . . . . . 411
Sudhir Singh, Niranjan Mishra, Subhrajit Raut,
and Debashish Pati
24 Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
Swati Gupta, Rosalin Kar, and Hemant Gupta
About the Editors
Akhilesh Kumar Singh graduated as a uni-
versity topper from KGMU, Lucknow. He
completed his postgraduation from
SCBMCH, Cuttack. He is a recipient of three
prestigious fellowships, i.e., Fellow of
International College of Surgeons (FICS) and
both International and Indian Board certified
Fellow in Oral and Maxillofacial Surgery
(FIBCSOMS and FIBOMS). He was also a
recipient of prestigious “Amar Kashyap
Bhargav Award” from International College
of Dentists. He is life member of various
national and international academic societies,
i.e., IAOO, FHNO, and AOMSI. He has been
National Faculty, Panelist, and Invited Guest
Speaker in various scientific conferences
across the country. He is also Editorial
Secretary of National Journal of Maxillofacial
Surgery. He has published around 40 research
papers in various renowned international and
national journals. Presently, he is working as
Associate Professor in Oral and Maxillofacial
Surgery Unit of IMS, BHU, Varanasi.
Naresh Kumar Sharma has completed his
graduation and postgraduation from King
George’s Medical University, Lucknow, in
2001. Presently, he is Professor in Oral and
Maxillofacial Surgery Unit, of IMS, BHU,
Varanasi. He has served as Dean and Head,
Faculty of Dental Sciences, BHU from 2014
to 2017. He published around 50 research
papers in various national and international
indexed journals. He has been acknowledged
as “Best Teacher” in Faculty of Dental
Sciences, Banaras Hindu University in 2014
and has been recognized as a Distinguished
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