Early Management of Gunshot Injuries to the Mandible and Mid Face

Abstract

To determine pattern and presentation in terms of site of injury, airway, associated injuries; and early management
of gunshot injuries to the mandible and mid face occurred in Tripoli -Libya from 2011 to 2018 .
A total of 409 patients were treated from 15th February 2011 to 15th February 2018 have been included. Medical
documentation of the patient was compiled. All the mandible & mid face gunshot and warfare injuries were treated
by oral and maxillofacial surgeon. Other concomitant bodily injuries were treated by pertinent consultant specialists.
A total of 409 patients with gunshot wounds to the face were identified. Age ranged from 15 to 42 years with mean
of 28+4.98 years. All patients are males. one hundred and nineteen patients (29.1%) required airway management. The most frequent site involved was mandible in 294 patients (71.9%) while mid-face was involved in 115
patients (28.1%). Open reduction and internal fixation (ORIF) was performed in 271 patients (66.3%), while 138
patients (33.7%) were managed conservatively. Out of 409 patients, 61 patients (14.9%) had some complications;
trismus, sinusitis and infection.
The most of our patient required surgical intervention for treatment of their mandible and mid face gunshot injuries.
Primary treatment of soft and skeletal facial structures at the time of surgical debridement was possible in the majority of our patients. Early management and operative intervention for repair of the soft and skeletal facial structures
leads to satisfactory results. Facial gunshot wounds frequently involve mandible with more likely requirement of
establishment of emergency airway and ( ORIF). The most soft tissue defects can closed by local flaps.