ABSTRACT
Over the past generation, the principle of precise open reduction and rigid internal fixation
with the use of low profile, biocompatible hardware has revolutionized the acute management
of facial trauma. The ability to achieve stepwise skeletal fragment reassembly, and accurate
reestablishment of facial projection, contour, and buttress support, has become more consistent
due to the availability of rigid internal fixation devices. Concurrently, modern techniques of
craniofacial reconstruction developed by Tessier and others have been extended for use in
trauma reconstruction. With this has come new routes to the injured craniofacial skeleton
(e.g., coronal and transconjunctival incisions, multi-incision minimal access approaches,
endoscopic techniques), the routine use of split calvarial bone grafts, and the introduction of
customized instrumentation (specialized power saws and drills, retractors, periosteal elevators,
lighting, etc.).
