War injuries of the middle third of the face may result from head-on crashes in motor and aviation accidents and from the unpredictable ravages of bullets or bomb fragments.
In crash accidents, when the head is thrown straight forward, severe comminution of the bones of the "interorbital region" (nasal pyramid, lacrimal and ethmoid bones) may result. Comminution and posterior displacement may produce considerable overriding of the fragments, as well as displacement of the internal palpebral ligament, resulting in a marked deformity (fig. 1 A). If the head is thrown forward while turned laterally, the malar region may present multiple fractures, with resultant displacement of the floor of the orbit into the antrum (fig. 5 A). It is evident that immediate replacement of the displaced bones is the method of choice. New methods of early treatment of such injuries have been described elsewhere.1
Two cases are presented to illustrate methods
CONVERSE JM. TWO PLASTIC OPERATIONS FOR REPAIR OF ORBIT FOLLOWING SEVERE TRAUMA AND EXTENSIVE COMMINUTED FRACTURE. Arch Ophthalmol. 1944;31(4):323–325. doi:10.1001/archopht.1944.00890040061010
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