Daily Bolus of LR: LeFort Fractures

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January 10, 2012 by dailybolusoflr

LeFort Fractures

 

·         Classification system to describe mid-face fractures

·         Le Fort I fracture

o   Is a transverse fracture through the maxilla (above the roots of the teeth)

o   Can be unilateral or bilateral

o   Patients may complain of their bite feeling abnormal

o   The maxilla may feel like it moves when the upper teeth are grasped and moved

·         Le Fort II fracture

o   Is usually bilateral and shaped like a pyramid

o   Fracture line extends up into the mid-face to include the nasal bridge, maxilla, lacrimal bones, orbital floor, and rim

o   This fracture is associated with infraorbital nerve hyperexthesias due to involvement of the orbital rim

o   The entire nasal complex moves with the maxilla when the teeth are grasped and moved

·         Le Fort III fracture

o   This is a rare fracture

o   Is a fracture of the connection between the elements of the skull and the face with fractures that start at the bridge of the nose and extend posteriorly along the medial wall of the orbit (ethmoids), along the floor of the orbit (maxilla) and through the lateral orbital wall, and finally break through the zygomatic arch.

o   They are often associated with a CSF leak

 

See visual representations here:

http://radiographics.rsna.org/content/26/3/783/F21.expansion.html

 

 

Ref: Rosen’s Emergency Medicine 7th ed

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