Immobilization of fractures of the facial skeleton: past and present

Craniomaxillofacial Surgery Techniques of 15th Century Turkish Surgeon Serefeddin Sabuncuoglu

INTRODUCTION

Şerefeddin Sabuncuoğlu, in his surgical medicine book entitled "Imperial Surgery" (Cerrâhiyetü'l-Hâniyye) that was published in the 15th century, described many diseases using colored miniatures, and explained the repair of these conditions using surgical methods and the required patient care after surgery. In his handwritten treatise, Sabuncuoğlu raised the curtain on his surgical methods with his illustrations. As a first in medical history, Sabuncuoğlu's book should be considered one of the most important original works from that era.

MATERIALS AND METHOD

The handwritten "Imperial Surgery" is presented in three chapters divided into 194 sections, and describing 147 surgical procedures with miniature drawings, 160 surgical instruments and 10 types of incision.

RESULTS

A separate chapter is allocated to craniomaxillofacial surgery in Imperial Surgery, containing 53 of the total 194 sections. The first chapter describes the use of branding (cauterization) for the treatment of headache and facial diseases. The second chapter describes the treatment of hydrocephalus, headache, vascular surgery, and the surgical treatment of tumors in the head and face. The third chapter describes in detail the treatment of cranial fractures, nasal fractures, mandibular fractures and mandibular dislocations.

CONCLUSION

The basic craniomaxillofacial surgery concepts, the descriptions of craniomaxillofacial diseases, the scales indicating the general patient conditions, and the surgical therapies, incisions, surgical instruments, postoperative care and complications put forward in the book are discussed in the present study. In the light of this seminal study, the authors of the present study suggest that Sabuncuoğlu should be considered and dignified as one of the leading pioneers of craniomaxillofacial surgery.

Mandibular fractures: Historical perspective

The principles of the treatment of mandibular fractures have changed recently, although the objective of re-establishing the occlusion and masticatory function remains the same. Splinting of teeth is an old way of immobilising fractures but the advent of modern biomaterials has changed clinical practice towards plating the bone and early restoration of function. We present a brief historical overview of techniques and systems that have been used for stabilisation of mandibular fractures.