Digital Workflow Integration in Acute Panfacial Fracture Management.
Michael V Joachim, Michael Miloro
✦ AI-curated · Sources linked
In 30 seconds
This systematic review assessed digital workflows—including virtual surgical planning, three-dimensional printing, and intraoperative navigation—for acute primary panfacial or complex multiregion facial fractures in adults. Five studies involving 82 subjects were included; heterogeneity prevented meta-analysis, so results were synthesized narratively. Intraoperative navigation was associated with a statistically significant reduction in mean operative time of 124.8 minutes (36.1% reduction; 95% CI, 68.5 to 181.2 minutes, P < .001). Integrated workflows also achieved reported reduction accuracy below the 2 mm threshold in the sole strictly panfacial cohort. Evidence quality varied from moderate to very low.
Key findings
- Intraoperative navigation reduced mean operative time by 124.8 minutes (36.1% reduction; 95% CI, 68.5 to 181.2 minutes, P < .001).
- In the only strictly panfacial cohort, integrated VSP and navigation achieved reduction accuracy below 2 mm across all facial thirds.
- In-house workflows had planning intervals from a mean of 4.2 hours to within 24 hours of CT acquisition, at approximately $597 USD per case.
- Evidence quality was moderate for operative time in one study, low for reduction accuracy and occlusal outcomes, and very low for the ballistic case series.
Why it matters
Acute panfacial fracture repair is technically demanding, and delays can constrain the use of digital planning and manufacturing. The review suggests that point-of-care workflows can be implemented within acute-care timelines and may improve operative efficiency and support accurate reduction. However, the small evidence base and variable certainty mean these findings are best viewed as promising rather than definitive.
What to keep in mind
Only five studies with 82 subjects were included, and substantial heterogeneity precluded meta-analysis. Evidence quality ranged from moderate to very low, limiting confidence in several outcomes.