53424 - Complicated Maxilla Fracture Open Reduction (No Plate)

The need for treatment of a complicated maxillary fracture involving viscera, blood vessels, or nerves, requiring open reduction without a plate, arises when a patient sustains a highly complex maxillary fracture—often from severe trauma like a gunshot wound—damaging adjacent structures such as the sinuses, major vessels, or nerves, necessitating surgical exposure under anesthesia with assistance in a hospital to reposition the bone and address complications without using a plate for fixation. This procedure is indicated for intricate fractures with soft tissue involvement, critical in the maxillofacial region where damage extends beyond bone to vital functions.

Specific conditions driving this need include:

• Severe trauma with visceral damage: A fracture piercing the sinus or orbital contents might require open reduction to manage visceral injury and realign the bone.
• Vascular involvement: Bleeding from a damaged maxillary artery could necessitate surgical exposure to control hemorrhage while repositioning the fracture.
• Nerve compromise: A fracture impinging on the infraorbital nerve might cause numbness, needing careful reduction to relieve pressure without plate fixation if stable.
• Complex instability: Multiple fracture lines with soft tissue damage could impair breathing or vision, requiring precise repositioning to restore function.

For instance, a patient with a maxillary fracture from a car crash involving sinus perforation might undergo open reduction to reposition the bone and repair visceral damage, with the assistant aiding in delicate nerve handling. In an aged care context, an elderly patient with a complicated maxillary injury could benefit from this to preserve breathing, adjusted for their frailty and comorbidities. By surgically repositioning the maxilla and managing complications without a plate, this service restores alignment, protects vital structures, and ensures healing, making it a specialised solution for complicated maxillary fractures within the maxillofacial framework.

Restores maxillary alignment, protects vital structures, and manages complications.

Recovery of 6-8 weeks with swelling, soft diet, and careful monitoring; hospital stay required.