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Residual complications associated with middle third facial fractures have been poorly documented in the literature. In the present study, 240 patients with fractures of the middle third of the facial skeleton, who were treated at the Royal Melbourne Hospital, Victoria, between 1969 and 1976, were reviewed to determine the residual complications of these fractures. Cranial complications were relatively uncommon, and 60 % of cases of cerebrospinal fluid rhinorrhoea ceased within 3 days of fracture reduction and fixation. Persistent infraorbital sensory defects occurred in 22 % of patients with Le Fort II or Le Fort III fractures. Orbital complications included diplopia, which remained in 8 % of cases, and was often corrected by secondary surgery. Residual complications involving the nose or maxillary sinus were uncommon (less than 5 %). Occlusal disharmony was present as a residual problem in 19.6 % of cases, although this could be managed by simple means in 89 % of these cases so that primary surgery and simple secondary dental procedures a satisfactory result in 98 % of all patients. The low incidence of dental complications is most likely a result of the rigid fixation employed in the fracture management, allowing accurate control of the bone fragments.

In a retrospective study of 240 patients with major fractures of the middle third of the facial skeleton, the incidence, anatomical patterns, and management of these fractures have been reviewed, and an assessment made of the concomitant injuries to other organs. Most of the fractures occurred in the 20-29-year age group (39%), and over 83% of the patients in this study were males. The most common cause of injury was road accidents (80.8% of all cases), and automobile occupants represented most of this group. The Le Fort II fracture was the most commonly sustained, and there were several variations from the classical fracture patterns recorded, combinations of fractures at different levels being frequent. Ninety percent of patients had another concomitant injury, indicating the need for multi-disciplinary care of this type of patient. The most common treatment method involved the use of craniomaxillary and intermaxillary fixation, which was usually maintained for 22-28 days.