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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 3 - Facial Plastics and Reconstructive Surgery

Midface Ballistic Fractures: A Retrospective Analysis and Proposed Management Algorithm

Tuesday, October 14, 2025
11:36 AM - 11:42 AM EDT
Location: 137
Introduction: Ballistic injuries to the midface present significant challenges due to the region's complex anatomy and the dual necessity of restoring function and aesthetics. The current literature lacks a structured approach to managing these injuries, highlighting a critical need for guidance to optimize outcomes in such complex cases.

Methods: We performed a single center retrospective review of 89 patients from 2020-2023 with gun shot wounds (GSWs) to the midface. Data was collected on patient demographics, injury characteristics, surgical interventions, and outcomes. The data was analyzed to identify trends and key factors influencing treatment decisions.

Results: Based on the collected data and outcomes, we developed an algorithm for managing midface ballistic fractures. Fractures involved the zygomaticomaxillary complex (35%), orbit (21%), and maxilla (16%). Treatments included observation (75%), open reduction and internal fixation (ORIF) (10%), and orbital implants (5%). The algorithm emphasizes selecting treatment options based on fracture complexity and anatomical involvement, focusing on achieving functional and structural restoration through a streamlined care approach.

Conclusions: Our study introduces one of the first structured algorithms for managing ballistic gunshot wound injuries to the midface, aiming to standardize care and enhance patient outcomes. By identifying key factors that influence treatment decisions, we hope to guide clinicians in optimizing both functional and aesthetic results for patients with these complex injuries.

    Presenting Author(s)

  • Travis Jonathan Clarke, MD

    Resident Physician
    University of Tennessee
    Memphis, TN, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Mohammad Almomani, MD

    Resident physician
    SSM/ SLU
    Memphis, Tennessee, United States

    Disclosure information not submitted.

  • AZ

    Aaron L. Zebolsky, MD

    Resident Physician
    University of Tennessee
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Emily R. Baker, MD

    Resident Physician
    Vanderbilt University Medical Center
    Memphis, Tennessee, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Anas A. Eid, MD

    Assistant Professor
    University of Tennessee, Department of Otolaryngology--Head and Neck Surgery
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • JK

    Jillian Krebs, N/A

    Student
    The Ohio State University, Dept. of Otolaryngology--Head and Neck Surgery
    Columbus, Ohio, United States

    Disclosure information not submitted.