Introduction: Pan facial fractures are defined as those involving the upper, middle, and lower thirds of face simultaneously. However clinically speaking, the term can be used if only 2 thirds of the face were involved. There is great controversy in the literature regarding sequence of repair of pan facial fractures, from inside to outside versus outside to inside, or top to buttom versus buttom to top. We introduced our experience for management of these cases.
Patients and methods: Retrospective multicentric study conducted at maxillofacial surgery unit, general surgery department, Sohag University, Sohag, Egypt. And king Fahd specialist hospital, Qassim province, Saudia Arabia. The study included all cases with panfacial fractures who presented and surgically treated between January 2017 to December 2021.
Results: Panfacial fractures involved the middle and lower thirds were the most common pattern (39.9%) followed by those involving the Upper, middle, and lower thirds (32.3%) and those affecting Upper and middle thirds (20.4%). The least pattern was Upper and lower thirds involvement (7.4%).
Conclusion: We customized the method for each patient in our study because there were a variety of fracture patterns. Actually, we fixed the static bones first, then the mobile ones. To ensure correct reduction and prevent compounding error by fixing following more comminuted fractured segments, it is advisable to start with less comminuted segments that have more visible reference points.