- LeFort fracture
LeFort fractures (also spelled as Le Fort fractures) are types of facial fractures that are classic in trauma.
Diagnosis
Diagnosis is by physician and is usually done in an Emergency room. The patient is taken for
radiography of the head and neck then after obvious fracture signs the patient is taken toCT scan where sharper images are produced. To qualify for LeFort Fractures thepterygoid plates must be involved. Also, look for mobilepalate in almost all cases.Classification
There are 3 types of LeFort fractures:
Le Fort I fractures (horizontal) may result from a force of injury directed low on the maxillary alveolar rim in a downward direction. The fracture extends from the nasal septum to the lateral pyriform rims, travels horizontally above the teeth apices, crosses below the zygomaticomaxillary junction, and traverses the pterygomaxillary junction to interrupt the pterygoid plates.
Le Fort II fractures (pyramidal) may result from a blow to the lower or mid maxilla. Such a fracture has a pyramidal shape and extends from the nasal bridge at or below the nasofrontal suture through the frontal processes of the maxilla, inferolaterally through the lacrimal bones and inferior orbital floor and rim through or near the inferior orbital foramen, and inferiorly through the anterior wall of the maxillary sinus; it then travels under the zygoma, across the pterygomaxillary fissure, and through the pterygoid plates.
Le Fort III fractures (transverse), also termed craniofacial disjunctions, may follow impact to the nasal bridge or upper maxilla. These fractures start at the nasofrontal and frontomaxillary sutures and extend posteriorly along the medial wall of the orbit through the nasolacrimal groove and ethmoid bones. The thicker sphenoid bone posteriorly usually prevents continuation of the fracture into the optic canal. Instead, the fracture continues along the floor of the orbit along the inferior orbital fissure and continues superolaterally through the lateral orbital wall, through the zygomaticofrontal junction and the zygomatic arch. Intranasally, a branch of the fracture extends through the base of the perpendicular plate of the ethmoid, through the vomer, and through the interface of the pterygoid plates to the base of the sphenoid.
Eponym
The Le Fort fracture was named after French
surgeon René Le Fort (1869-1951).ee also
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Oral and maxillofacial surgery External links
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* [http://www.emedicine.com/plastic/topic481.htm eMedicine - Facial Trauma,Maxillary and Le Fort Fractures]
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