Delayed management of facial fractures

It is generally agreed that best results in the treatment of facial fractures may be expected if the reduction is done within the first few days after the injury; unfortunately, due to a number of factors, this is not always possible. Excluding inevitable delay associated with distance from a suitable medical unit, and failure of complete diagnosis and appreciation of the facial injury, the most frequent reasons for delaying the treatment of facial fractures are serious concomitant injuries which take precedence in management. The most common of these, and certainly the most serious, is a cerebral injury; yet, despite the fact that neurologic levels usually become stable within 10 days after injury, some of these accident victims continue to receive attention to their more obvious injuries, and repair of the facial skeleton is frequently postponed too long, and thus, for one reason or another, delay in specific treatment is not an uncommon sequence following admission to hospital.