Le Fort fractures

Classification

Le Fort I

LeFort Type 1
Le Fort 1 Fracture
  • 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

Retrieved from "https://www.wikem.org/w/index.php?title=Le_Fort_fractures&oldid=25800"