Reconstruction of Anterior Maxillary Defect Following Gunshot Injury: A Case Report

Objectives: To present a case of complex anterior maxillary defect caused by a gunshot injury and discuss the surgical approach using an autologous bone graft and a mini free flap for reconstruction. Materials and Methods: A 15-year-old male presented with maxillofacial trauma, including mandibular and anterior maxillary fractures, following a gunshot injury. Initial management involved mandibular fixation, nasal base stabilization, and primary mucosal repair. Subsequent imaging revealed a 4x2 cm anterior maxillary defect and upper lip contracture. Reconstruction was performed using a 4x2 cm autologous iliac crest bone graft and a 5x4 cm mini free flap harvested from the lower extremity. Microvascular anastomosis was conducted with the facial artery and vein. Results: Postoperative recovery was uneventful, and at the one-year follow-up, the patient exhibited significant improvements in aesthetic and functional outcomes. The bone graft demonstrated successful integration, and the free flap-maintained viability without complications. Conclusion: Combining autologous bone grafts with free flaps provides effective functional and aesthetic restoration for gunshot-induced maxillofacial defects. This case underscores the importance of a multidisciplinary approach and highlights strategies for optimizing outcomes in complex maxillofacial reconstructions.