Frequently, patients with facial fractures also have lacerations. Very often, these existing soft-tissue injuries can be used to directly access the facial bones for management of the fractures.
The intraoral approach is the usual access for simple fractures of the body, symphysis, and angular regions.
The intraoral approach is used for the majority of simple angle fractures.
The submental approach is used to treat fractures of the anterior mandibular body and symphysis.
This approach is selected for fractures of the mandibular body and angle regions unsuitable for intraoral treatment.
The retromandibular approaches expose the entire ramus from behind the posterior border. They therefore may be useful for procedures involving the area on or near the condylar process/head, or the ramus itself.
The facelift approach provides the same exposure as the retromandibular and preauricular accesses combined. The only difference is that the skin incision is placed in a more cosmetically acceptable location.
The preauricular approach can be used to access and treat fractures in the mandibular condylar head and neck region.
The ramus and condyle region can be exposed via an intraoral approach by extending the standard vestibular incision in a superior direction up the ascending ramus.
The safe zones for pin placement are located circumferentially around the whole continuity of the mandible along the lower and posterior borders and the condylar processes.