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A 22-year-old woman sustained ocular laceration complicated by extensive an eyelid degloving injury when she accidentally fell and the drinking glass in her hand broke and cut her in the right eye area. She immediately noticed significant vision loss; thus, early surgical intervention was performed in collaboration with ophthalmologists and plastic surgeons. At 16 months after the injury, a good visual prognosis was achieved (visual acuity >20/40: IOL) without eye movement disorder or eyelid opening disorder, and phthisis bulbi and the need for prosthetic eye wear were avoided. Functional and cosmetic reconstruction can be achieved with concurrent emergency surgical intervention by ophthalmologists and plastic surgeons, even in cases of ocular laceration complicated by extensive eyelid degloving injury, where blindness and phthisis bulbi are predicted.

A 48-year-old man sustained a severe punching hole injury of 8 cm in diameter on the palm of his left hand using a punching instrument (for making the bottom of drink cans), and his middle and ring fingers were almost amputated. A flow-through type immediate ALT (anterolateral thigh) flap was used to bypass the distal blood flow and a titanium plate for mandibular reconstruction and plantar glabrous skin were used to preserve the floating amputated fingers. As there has been no report of reconstruction of a punching hole in the palmar region that exceeds 8 cm in diameter, this report is novel and educational.

In general, internal plate fixation is mainly performed in order to reduce multiple facial bone fractures and rarely uses an external fixator. Although it would be ideal to successfully achieve or preserve the occlusal relationship of the upper and lower jaws, it is difficult to successfully manage multiple bone fragments in order to use them to achieve internal fixation, especially when treating a severely comminuted facial fracture. In addition, it is also important to prevent the onset of severe infection after sub-periosteal dissection, due to the presence of avascular bony fragments and an internal fixation implant which thus represents a foreign body. In order to treat extensive comminuted fracture without internal plate fixation, we performed external fixation using an Ilizarov-type external fixator. The Ilizarov-type external fixator is characterized by a few circular external structures and threaded rods. This device can be modified for use in the field of orthopedic surgery to correct three-dimensional deformities caused by fragile complicated fractures and bone defects. The advantages of the Ilizarov-type external fixator for treating panfacial fractures include a low invasiveness, utility in various fracture situations, easy adjustment of threaded rods, and a low potential cost. We herein report the first case of a severe panfacial fracture that was successfully treated using an Ilizarov-type external fixator. Keywords: Panfacial fracture, Comminuted facial fracture, Implant infection, Ilizarov-type external fixator, External fixation devices, Bone extending devices