Comminuted Midface Fracture

Facial injuries are usually treated by a maxillofacial surgeon trained in this field. Road traffic accidents (RTAs) contribute significantly to mortality and morbidity, especially among young adults. The World Health Organization identifies RTAs as a leading cause of death and disability due to rapid urbanization, increased vehicular use, poor road safety measures, and lack of enforcement of traffic regulations. Maxillofacial trauma constitutes a critical subset of injuries due to its potential functional and aesthetic consequences. The midface region is especially susceptible owing to its anatomical prominence and complex skeletal architecture. Fractures in this area often involve the maxilla, zygomaticomaxillary complex, orbit, nasal bones, and naso-orbito-ethmoidal (NOE) complex. Such injuries can compromise vision, breathing, mastication, speech, and facial esthetics, significantly affecting quality of life. High-impact midface fractures coexist with head injuries, cervical spine trauma, and systemic injuries, thereby complicating diagnosis and management. This paper presents a case report of upper maxillofacial region fractures in a pillion rider of a scooter. The patient presented with facial swelling, periorbital ecchymosis, nasal deformity, malocclusion, infraorbital nerve paraesthesia, epistaxis, and cerebrospinal fluid rhinorrhea, and was diagnosed as NOE type III type of midfacial injury. This case highlights the need for thorough clinical and radiological assessment along with advanced diagnostic imaging techniques, in association with the right technical and surgical skills. Moreover, the use of rigid internal fixation techniques has greatly improved outcomes, allowing for precise anatomical reduction and early restoration of function. However, prevention through seatbelt compliance, helmet use, road safety awareness, and legislative enforcement remains the most effective strategy for reducing the burden of such injuries.