Primary Reconstruction of Gunshot Fractures of the Facial Skeleton and Skull
How early can definitive fixation be performed after a gunshot injury—and when does a plate create more risk than benefit? Maxillofacial surgeon Mykola Zhuzhoma presents the experience of a military clinical centre treating complex facial and neck trauma, including its patient data from 2022–2025.
The lecture follows several severe combined-injury cases from initial assessment to staged surgery. It covers airway protection, primary surgical debridement, preservation of viable bone fragments, dental splinting, restoration of occlusion, open reduction and fixation with titanium plates and mesh, soft-tissue repair and postoperative imaging.
The discussion moves beyond ideal algorithms to decisions shaped by infection, evacuation time, limited specialist availability and major tissue loss. The Q&A explores delayed osteosynthesis, temporary stabilisation, facial buttresses, haemorrhage control and the anatomical defect that remains particularly difficult even for an experienced reconstructive team.
The lecture follows several severe combined-injury cases from initial assessment to staged surgery. It covers airway protection, primary surgical debridement, preservation of viable bone fragments, dental splinting, restoration of occlusion, open reduction and fixation with titanium plates and mesh, soft-tissue repair and postoperative imaging.
The discussion moves beyond ideal algorithms to decisions shaped by infection, evacuation time, limited specialist availability and major tissue loss. The Q&A explores delayed osteosynthesis, temporary stabilisation, facial buttresses, haemorrhage control and the anatomical defect that remains particularly difficult even for an experienced reconstructive team.