A. Bouaichi

Réduction des fractures de l’arcade zygomatique par pince fixe-champ

INTRODUCTION Isolated fractures of the zygomatic arch (IFZA) are common in maxillofacial emergencies. They usually require a closed reduction. Several reduction techniques have been proposed. The reduction using a Ginestet-type hook is the gold standard technique. DISCUSSION The reduction using a towel clip under local anesthesia is an economical, simple, reliable and safe alternative technique for the reduction of IFZA. We describe this procedure.

L’intubation sous-mentonnière en traumatologie maxillofaciale

INTRODUCTION Free access to the upper respiratory tract may be a challenge for the management of severe facial trauma. Tracheotomy is routinely used in this case. Submental intubation is little used, but it is an alternative to tracheotomy. MATERIAL AND METHOD A retrospective study was made over 1 year. Sixteen patients with facial smash were included. Patients who had undergone an immediate tracheotomy or a long-term intubation were excluded. Submental intubation was used in all patients with the same protocol. The studied data was: operative time, duration of ventilator disconnection, postoperative complications, and scar assessment. RESULTS The average operative time was seven minutes. No speech disorder, hematoma, or postoperative infection was observed. The scar was barely visible in 13 cases out of 16. DISCUSSION Submental intubation seems to be a reliable, simple and easy to learn technique. A perfect knowledge of the local anatomy allows opening the airway without any risk of hematoma. Incision packing reduces the bacterial inoculum and infectious risk. The residual scarring is minimal.

Plaies faciales : étude épidémiologique de 850 cas

BACKGROUND Facial wound are among the most frequent emergencies. They often affect a young population. We studied the epidemiological profile of facial wounds admitted in our hospital. PATIENTS AND METHODS This prospective study was carried out in the Emergency Unit from June 2008 to June 2009. It included all patients having presented with at least one facial wound. The analysed parameters were patient, trauma, and wound characteristics. RESULTS Eight hundred and fifty patients were included, 20% of whom were female patients. The most frequent etiologies were traffic accidents for men, assault for women, and domestic accidents for children. Alcohol abuse was involved in 12.4% of the cases. The most frequent wound localization was frontal (35.4%). A craniofacial organ (eye, brain…) was affected in 6.1% of the cases; the wound was associated to a craniofacial fracture in 9.6% of the cases, and to an extrafacial lesion in 22% of the cases. DISCUSSION Facial wounds are a frequent emergency. They are predominant in young male patients. The high frequency of traffic accident and alcohol abuse requires an adequate prevention policy.