No widely accepted definition of CFFx or panfacial fracture
Definitions include
Severely comminuted fractures involving multiple facial bones that do not follow pattern described for traditional transfacial (Le Fort) fracture
Fractures involving upper, middle, & lower face (nasoorbitalethmoidal, zygomaticomaxillary complex, central midface, & mandible)
Fracture patterns involving both midface & mandible
IMAGING
General Features
Imaging Recommendations
CT Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Alasraj A et al: Does intraoperative computed tomography scanning in maxillofacial trauma surgery affect the revision rate? J Oral Maxillofac Surg. 79(2):412-9, 2021
Cuddy K et al: Management of zygomaticomaxillary complex fractures utilizing intraoperative 3-dimensional imaging: the ZYGOMAS protocol. J Oral Maxillofac Surg. 79(1):177-82, 2021
Causbie J et al: Complications following orbital floor repair: impact of intraoperative computed tomography scan and implant material. Facial Plast Surg Aesthet Med. ePub, 2020
Gabrick K et al: Radiographic predictors of FACE-Q outcomes following non-operative orbital floor fracture management. J Craniofac Surg. 31(4):e388-91, 2020
Pontell ME et al: Influence of radiographic soft tissue findings on clinical entrapment in patients with orbital fractures. J Craniofac Surg. ePub, 2020
Cornelius CP et al: The comprehensive AOCMF classification system: midface fractures - level 3 tutorial. Craniomaxillofac Trauma Reconstr. 7(Suppl 1):S068-91, 2014
Morrison CS et al: Use of intraoperative computed tomography in complex craniofacial trauma: an example of on-table change in management. Craniomaxillofac Trauma Reconstr. 7(4):298-301, 2014
Uzelac A et al: Orbital and facial fractures. Neuroimaging Clin N Am. 24(3):407-24, vii, 2014
Chung KJ et al: Treatment of complex facial fractures: clinical experience of different timing and order. J Craniofac Surg. 24(1):216-20, 2013
de Melo WM et al: Using the "bottom-up and outside-in" sequence for panfacial fracture management: does it provide a clinical significance? J Craniofac Surg. 24(5):e479-81, 2013
Mundinger GS et al: Blunt-mechanism facial fracture patterns associated with internal carotid artery injuries: recommendations for additional screening criteria based on analysis of 4,398 patients. J Oral Maxillofac Surg. 71(12):2092-100, 2013
Winegar BA et al: Spectrum of critical imaging findings in complex facial skeletal trauma. Radiographics. 33(1):3-19, 2013
Ahmad Z et al: Towards a classification system for complex craniofacial fractures. Br J Oral Maxillofac Surg. 50(6):490-4, 2012
Bell RB: Computer planning and intraoperative navigation in cranio-maxillofacial surgery. Oral Maxillofac Surg Clin North Am. 22(1):135-56, 2010
Canter HI et al: Use of rigid external distraction device in treatment of complex maxillofacial fractures. J Craniofac Surg. 19(2):306-12, 2008
He D et al: Panfacial fractures: analysis of 33 cases treated late. J Oral Maxillofac Surg. 65(12):2459-65, 2007
Sargent LA: Nasoethmoid orbital fractures: diagnosis and treatment. Plast Reconstr Surg. 120(7 Suppl 2):16S-31S, 2007
Saigal K et al: Use of three-dimensional computerized tomography reconstruction in complex facial trauma. Facial Plast Surg. 21(3):214-20, 2005
Clauser L et al: Severe panfacial fracture with facial explosion: integrated and multistaged reconstructive procedures. J Craniofac Surg. 14(6):893-8, 2003
Buitrago-Téllez CH et al: A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography. Injury. 33(8):651-68, 2002
Girotto JA et al: Long-term physical impairment and functional outcomes after complex facial fractures. Plast Reconstr Surg. 108(2):312-27, 2001
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Complex facial fracture (CFFx)
Synonyms
Facial smash injury, panfacial fracture
Definitions
No widely accepted definition of CFFx or panfacial fracture
Definitions include
Severely comminuted fractures involving multiple facial bones that do not follow pattern described for traditional transfacial (Le Fort) fracture
Fractures involving upper, middle, & lower face (nasoorbitalethmoidal, zygomaticomaxillary complex, central midface, & mandible)
Fracture patterns involving both midface & mandible
IMAGING
General Features
Imaging Recommendations
CT Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Alasraj A et al: Does intraoperative computed tomography scanning in maxillofacial trauma surgery affect the revision rate? J Oral Maxillofac Surg. 79(2):412-9, 2021
Cuddy K et al: Management of zygomaticomaxillary complex fractures utilizing intraoperative 3-dimensional imaging: the ZYGOMAS protocol. J Oral Maxillofac Surg. 79(1):177-82, 2021
Causbie J et al: Complications following orbital floor repair: impact of intraoperative computed tomography scan and implant material. Facial Plast Surg Aesthet Med. ePub, 2020
Gabrick K et al: Radiographic predictors of FACE-Q outcomes following non-operative orbital floor fracture management. J Craniofac Surg. 31(4):e388-91, 2020
Pontell ME et al: Influence of radiographic soft tissue findings on clinical entrapment in patients with orbital fractures. J Craniofac Surg. ePub, 2020
Cornelius CP et al: The comprehensive AOCMF classification system: midface fractures - level 3 tutorial. Craniomaxillofac Trauma Reconstr. 7(Suppl 1):S068-91, 2014
Morrison CS et al: Use of intraoperative computed tomography in complex craniofacial trauma: an example of on-table change in management. Craniomaxillofac Trauma Reconstr. 7(4):298-301, 2014
Uzelac A et al: Orbital and facial fractures. Neuroimaging Clin N Am. 24(3):407-24, vii, 2014
Chung KJ et al: Treatment of complex facial fractures: clinical experience of different timing and order. J Craniofac Surg. 24(1):216-20, 2013
de Melo WM et al: Using the "bottom-up and outside-in" sequence for panfacial fracture management: does it provide a clinical significance? J Craniofac Surg. 24(5):e479-81, 2013
Mundinger GS et al: Blunt-mechanism facial fracture patterns associated with internal carotid artery injuries: recommendations for additional screening criteria based on analysis of 4,398 patients. J Oral Maxillofac Surg. 71(12):2092-100, 2013
Winegar BA et al: Spectrum of critical imaging findings in complex facial skeletal trauma. Radiographics. 33(1):3-19, 2013
Ahmad Z et al: Towards a classification system for complex craniofacial fractures. Br J Oral Maxillofac Surg. 50(6):490-4, 2012
Bell RB: Computer planning and intraoperative navigation in cranio-maxillofacial surgery. Oral Maxillofac Surg Clin North Am. 22(1):135-56, 2010
Canter HI et al: Use of rigid external distraction device in treatment of complex maxillofacial fractures. J Craniofac Surg. 19(2):306-12, 2008
He D et al: Panfacial fractures: analysis of 33 cases treated late. J Oral Maxillofac Surg. 65(12):2459-65, 2007
Sargent LA: Nasoethmoid orbital fractures: diagnosis and treatment. Plast Reconstr Surg. 120(7 Suppl 2):16S-31S, 2007
Saigal K et al: Use of three-dimensional computerized tomography reconstruction in complex facial trauma. Facial Plast Surg. 21(3):214-20, 2005
Clauser L et al: Severe panfacial fracture with facial explosion: integrated and multistaged reconstructive procedures. J Craniofac Surg. 14(6):893-8, 2003
Buitrago-Téllez CH et al: A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography. Injury. 33(8):651-68, 2002
Girotto JA et al: Long-term physical impairment and functional outcomes after complex facial fractures. Plast Reconstr Surg. 108(2):312-27, 2001
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