Nursing Care of a Patient With Postoperative Complications Following LeFort III Osteotomy Combined With External Distraction

This case report describes the clinical management and nursing care of a 9-year-old boy with Crouzon syndrome who developed complications following LeFort III osteotomy with external distraction. Two weeks after the initial procedure, the patient presented with loosening of the external distraction frame, skull fracture, cerebrospinal fluid leakage, and MRSA-associated dural infection. He underwent revision surgery involving device repositioning, meticulous debridement, periosteal flap repair, targeted antimicrobial therapy, and closed irrigation drainage. A comprehensive nursing protocol was implemented, emphasizing infection control, monitoring for cerebrospinal fluid leakage and intracranial hypertension, maintenance of the distraction system, oral hygiene, and psychological support. Continued midface distraction using a facial bow allowed successful completion of the treatment course. Over 2 years of follow-up, the patient demonstrated significant improvement in craniofacial morphology, ocular prominence, and psychosocial functioning, highlighting the importance of timely intervention and coordinated multidisciplinary care in managing postoperative complications of craniofacial distraction.