The use of immediate grafting in facial fracture management. Indications and clinical considerations.

One of the goals of reconstruction of the craniomaxillofacial skeleton following major trauma has been the one-stage repair of form and function. This goal can be achieved by the application of craniofacial techniques, careful interfragmentary stabilization, and primary bone grafting even in the most severe of injuries. Primary bone grafting, only recently achieving wide acceptance, has proven to be an important clinical advance allowing definitive one-stage repair in previously extremely difficult situations. The results are reproducible and predictable. In many centers, consistently superior end results are achieved for patients after the primary reconstruction. Future trends in facial fracture and trauma management now incorporate these concepts into the armamentarium of the reconstructive surgeon.