Le Fort fractures: Difference between revisions
m (Rossdonaldson1 moved page Le Fort Fractures to Le Fort fractures) |
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*Le Fort III plus involvement of frontal bone | *Le Fort III plus involvement of frontal bone | ||
*Unstable fx | *Unstable fx | ||
==Differential Diagnosis== | |||
{{Maxillofacial trauma DDX}} | |||
==Management== | ==Management== |
Revision as of 08:34, 10 January 2015
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
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
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