Complex Traumatic Degloving Facial Injury with Multiple Maxillofacial Fractures: A Case Report

Abstract

Reconstructing mutilating soft-tissue injuries, lacerations, and extensive degloving injuries of the face is a very challenging and exacting task, It becomes more challenging and difficult if these types of injuries are associated with maxillofacial fractures. Such injuries require meticulous treatment and care; inadequate and poor treatment may lead to grotesque unsightly deformities, with inevitable physiological and psychological ill-effects. It requires a staged treatment method for optimal and successful aesthetic and functional outcomes. Meticulous anatomic repositioning of soft tissues as well as hard tissues, and proper postoperatively gives good aesthetic and functional results. The present article presents a case of 45-year-old male patient of a complex traumatic degloving soft-tissue injury along with multiple facial bone fractures, detailing the measures taken to prevent necrosis and infection through surgical debridement, internal fixation of maxillofacial fractures, and timely restoration of vital soft-tissue elements in position. Following a road traffic accident, the patient was diagnosed with a frontal bone fracture, Lefort-II fracture with a comminuted parasymphysis fracture of the mandible, and a degloving injury to the lower lip. Open Reduction and Internal Fixation (ORIF) were performed for the mandibular fracture, and an autologous cancellous bone graft from the anterior iliac crest was grafted to bridge the gap between fractured segments. Intermaxillary Fixation (IMF) (Closed reduction) was done for the midface fracture. Meticulous multiple-layered suturing was performed for the degloving soft-tissue injury. After three months, there were no complications, and the patient was satisfied with no functional or aesthetic deficits.