Le Fort fractures: Difference between revisions
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*Type II and III injuries associated with cribriform plate disruption and CSF rhinorrhea | *Type II and III injuries associated with cribriform plate disruption and CSF rhinorrhea | ||
== | ==Clinical Features== | ||
{| class="wikitable | |||
==Differential Diagnosis== | |||
{{Maxillofacial trauma DDX}} | |||
==Evaluation== | |||
===Workup=== | |||
[[File:LeFort109M.jpg|thumb|A 3-D CT reconstruction showing a Le Fort type 1 fracture (marked by arrow).]] | |||
*CT sinus/face | |||
===Diagnosis=== | |||
{| class="wikitable" | |||
| align="center" style="background:#f0f0f0;"|'''Le Fort Fracture''' | | align="center" style="background:#f0f0f0;"|'''Le Fort Fracture''' | ||
| align="center" style="background:#f0f0f0;"|'''Description''' | | align="center" style="background:#f0f0f0;"|'''Description''' | ||
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||||||Unstable | ||||||Unstable | ||
|} | |} | ||
==Management== | ==Management== |
Revision as of 06:47, 10 May 2019
Background
- Midface fracture involving the maxilla and surrounding facial structures
- Most commonly occur due to motor vehicle accident
- LeFort I fractures are isolated to the lower face
- Type II and III injuries associated with cribriform plate disruption and CSF rhinorrhea
Clinical Features
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Evaluation
Workup
- CT sinus/face
Diagnosis
Le Fort Fracture | Description | Front View | Side View | Stability |
Type I |
|
Stable | ||
Type II |
|
Can be stable or unstable fracture | ||
Type III |
|
Unstable | ||
Type IV |
|
Unstable |
Management
- Ensure airway patency
- If intubation required, consider awake intubation
- Control hemorrhage
- Nasal and oral packing may be required
- IV antibiotics
Disposition
- Consider discharge in isolated LeFort I or stable LeFort II fractures without concerning features (in coordination with appropriate specialist consult - OMFS, ENT, or PRS)
- All others should be admitted
See Also
References
- ↑ Tintinalli 7th Edition, pgs 1730-1738