53427 - Complicated Maxilla Fracture Open Reduction with Plate

The need for treatment of a complicated maxillary fracture involving viscera, blood vessels, or nerves, requiring open reduction and plating, arises when a patient sustains a severely complex maxillary fracture—often from catastrophic trauma like a blast injury—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 secure it with a plate for robust stabilisation. This procedure is indicated for the most intricate maxillary fractures with soft tissue involvement, critical in the maxillofacial region where extensive damage affects vital functions and facial integrity.

Specific conditions driving this need include:

• Catastrophic trauma with visceral damage: A fracture breaching the sinus or orbit might require open reduction and plating to stabilise the bone and repair visceral injury.
• Vascular compromise: Severe bleeding from maxillary vessels could necessitate surgical control and plating to ensure stability during healing.
• Nerve damage: A fracture impacting the infraorbital nerve might cause sensory loss, needing reduction and plate fixation to relieve pressure and maintain alignment.
• Structural collapse: Extensive maxillary shattering could impair breathing or vision, requiring plating to rebuild and stabilise the midface.

For instance, a patient with a maxillary fracture from a workplace explosion involving sinus rupture might undergo open reduction with a plate to restore structure and protect vision, with the assistant ensuring precise plate placement. In an aged care context, an elderly patient with a complicated maxillary injury could benefit from this to preserve function, adjusted for their frailty and comorbidities. By surgically repositioning and plating the maxilla, this service provides durable stability, protects vital structures, and manages complications, making it an advanced solution for the most severe maxillary fractures within the maxillofacial framework.

Provides durable maxillary stability, protects vital structures, and restores function.

Recovery of 6-10 weeks with swelling, soft diet, and plate monitoring; hospital stay required.