Evidence-Based Facial Fracture Management

With demands for an evidence-based approach to patient care, the management of facial fractures will come under increasing scrutiny because there is an overall deficiency in higher level clinical evidence. This article reviews the management of facial fractures, focusing on an evidence-based approach. It focuses on select areas of facial trauma in which there is controversy and presents randomized studies and meta-analysis to help define best practice. The article notes the many areas where the evidenced-based literature is weak and looks at the future of evidence-based facial trauma care.

Key points

•

The facial trauma literature primarily consists of lower-level evidence, including retrospective case series and case reports.
•

There is strong clinical evidence from meta-analysis to guide antibiotic use in facial trauma.
•

There is solid clinical evidence from meta-analysis of clinical trials supporting the use of general anesthesia for closed nasal reduction.
•

There is no consensus from the literature on the best method of treating mandible fractures.
•

Systematic review of the literature suggests improved patient outcomes with open reduction for displaced fractures of the mandibular condyle.