Le Fort fractures: Difference between revisions
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*Pyramidal fx through central maxilla and hard palate | *Pyramidal fx through central maxilla and hard palate | ||
*Movement of hard palate and nose occurs, but not the eyes | *Movement of hard palate and nose occurs, but not the eyes | ||
*Can be stable or unstable fx | |||
===Le Fort III=== | |||
*Craniofacial dysjunction (fx through frontozygomatic sutures, orbit, nose, ethmoids) | |||
*Entire face shifts w/ globes held in place only by optic nerve) | |||
*Dish face deformity on lateral view | |||
*Unstable fx | |||
===Le Fort IV=== | |||
*Le Fort III plus involvement of frontal bone | |||
*Unstable fx | |||
==Management== | ==Management== | ||
Revision as of 15:00, 5 November 2014
Classification
Le Fort I
- Transverse fx separating body of maxilla from pterygoid plate and nasal septum
- Only hard palate and teeth move (when rock hard palate while stabilizing forehead)
- Stable fx
Le Fort II
- Pyramidal fx through central maxilla and hard palate
- Movement of hard palate and nose occurs, but not the eyes
- Can be stable or unstable fx
Le Fort III
- Craniofacial dysjunction (fx through frontozygomatic sutures, orbit, nose, ethmoids)
- Entire face shifts w/ globes held in place only by optic nerve)
- Dish face deformity on lateral view
- Unstable fx
Le Fort IV
- Le Fort III plus involvement of frontal bone
- Unstable fx
Management
- Airway protection
- Consider awake intubation (eg, ketamine) if need airway; if possible do not paralyze a Le Fort for intubation or you may be forced into a crash surgical airway
- Prepare for surgical airway
- CT Face
- Control hemorrhage w/ nasal and oral packing if needed
- Admit for IV abx and sx
See Also
Source
Tintinalli