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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 1998 August;157(4):121-5

language: Italian

Maxillofacial fractures in the elderly

Becelli R., Frati R., Renzi G.

Università degli Studi «La Sapienza» - Roma, Cattedra di Chirurgia Maxillofacciale


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Background and aims. This paper discusses the problems linked to the diagnosis and treatment of maxillofacial fractures in the elderly.
Methods. A retrospective study was carried out in 51 patients aged over 65 years-old treated for maxillofacial fractures at the Department of Maxillofacial Surgery at “La Sapienza” University of Rome between January 1981 and October 1997.
Results. Maxillary or zygomatic fractures were the maxillofacial fractures most frequently diagnosed in this series. The most severe fractures were reduced and restrained using methods like RIF, intermaxillary locking or bicortical screws, depending on the site of trauma and the capacity of tissues to support surgical or non-surgical techniques. In 29 cases no treatment was performed, but patients were only kept under observation owing to the general conditions of the patient and the scant functional disorders caused by the trauma.
Conclusions. The most correct treatment for maxillofacial injuries in the elderly is to proceed with surgery at an early stage, on the first or second day. Treatment is then carried out in ideal conditions: before the edematous swelling of tissues and before spontaneous fracture repair can lead to functional and cosmetic damage which is difficult to correct.
Therefore, a prompt diagnosis based on objective examination and instrumental imaging, is undoubtedly important for the final outcome of surgery in both functional and cosmetic terms.

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