A Retrospective Analysis of Panfacial Fractures: Pattern of Injury and Short-Term Clinical Outcome

Objective: The current work aimed to analyze the characteristics patterns of panfacial fractures [PFFs] and its associated outcome. 
Methodology: We retrospectively analyzed files of 41 patients with PFFs from June 2018 to June 2022. Files were reviewed for patient demographics, preoperative assessment, surgical intervention, and treatment outcome. The diagnosis was established by clinical and radiological evaluation. The pattern of PFFs was classified into five categories on the basis of included facial bone. 1] upper midfacial, lower midfacial and mandibular [ULM]; 2] frontal, upper and lower midfacial bones [FUL]; 3] frontal, upper midfacial and mandibular bones [FUM] and; 4] Fracture of the four bones [FULM], and 5] FLM.  Concomitant body injuries were document and treatment were performed by multidisciplinary team [combined treatment]. Early postoperative complications were documented and categorized according to Clavien-Dindo classification system. 
Results: The commonest pattern was ULM [21 patients; 51.2%], FUL [12 patients; 29.3%] and FULM [8 patients; 19.5%]. There was significant association between the pattern of injury and patient’s age and etiology [ULM were the oldest, while FULM was the youngest. The FULM was mainly due industrial, ULM and FUL were due to road traffic accident]. Males were predominantly in all patterns with no significant differences. The pattern was also significantly associated with operative time and early postoperative complications [The FULM had the longest operative time, then FUL and ULM]. All patients in FULM pattern had early postoperative complications, compared to 75% in FUL and 66.7% in the ULM pattern. The mortality was only reported in FULM pattern [2 patients]. 
Conclusion: The ULM pattern was the commonest and PFFs patterns are associated with patient age, etiology, operative time and early postoperative complications. Defining the PFFs pattern could be an initial triage in a systemic management approach to improve clinical outcome.