The most important feature is the presence of a pterygoid fracture, which is found in all Le Fort fractures types. Author present the case who diagnosed Le Fort I fracture. Higher grade Le Fort fractures were also associated with increased rates of concomitant head and neck injuries that most commonly involved skull fracture Rarely, uncontrollable hemorrhage will necessitate angiography and embolization. Arch Facial Plast Surg.
Le Fort fracture of skull
Arch bars should be applied to the dentition when present. In one study, surgeons were able to remove the fixation in 30 seconds, but nonsurgical hospital staff took more than 2 minutes Goss et al. Thus, most significant maxillary fractures should be reduced and repaired surgically. Take a quiz of the questions on this article. An armor-reinforced tube is recommended to prevent kinking.
Management of Le Fort I fracture
Generally, a radiologist has a low degree of confidence in MRI findings when assessing a facial fracture; MRI plays an adjunctive role in the examination. As addressed later, bone defects after reduction of the maxilla should be grafted immediately. National Center for Biotechnology Information , U. The plates and screws fixed both the zygomaticomaxillary buttress and piriform aperture. They may involve craniofacial avulsion basal, pyramidal or high avulsion , as opposed to non-classifiable fractures comminuted fractures, defect fractures. Another classification system is the Wassmund system.
Two-dimensional face CT scans and 3-dimensional reconstructive scans may be required for diagnosis and after surgery to confirm correction of the fracture. A basic series of X-rays may be sufficient in some cases to assess the fracture if a CT scan cannot be performed or there is no indication of a midface or maxillary fracture. Indications Extensive maxillary fractures are usually associated with significant cosmetic and functional sequelae. Commonly, patients released from IMF early and patients having late fracture reduction where IMF was placed late after the initial injury would be observed to have a small anterior open bite after the release of IMF. However, those patients with complicated midface fractures Le Fort III or panfacial fractures can present a dilemma. Using this system, fractures are classified by the number of MRUs involved Table 5.