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  • Maxillary Fractures

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    JacqColumna
    49 vues22 pages
    The document discusses Le fort fractures, which result from forces applied to the maxilla in different locations. A Le fort I fracture separates the maxilla from the pterygoid plates. A Le fort II fracture separates the maxilla and nasal complex from the orbits. A Le fort III fracture is the most severe, separating the midface from the cranial base through fractures of the zygomatic bones, orbits, and pterygoid plates. Clinical findings vary depending on the type of Le fort fracture but may include swelling, malocclusion, ecchymosis, and mobility of the maxilla.

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    The document discusses Le fort fractures, which result from forces applied to the maxilla in different locations. A Le fort I fracture separates the maxilla from the pterygoid plates. A Le fort II fracture separates the maxilla and nasal complex from the orbits. A Le fort III fracture is the most severe, separating the midface from the cranial base through fractures of the zygomatic bones, orbits, and pterygoid plates. Clinical findings vary depending on the type of Le fort fracture but may include swelling, malocclusion, ecchymosis, and mobility of the maxilla.

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    49 vues22 pages

    Maxillary Fractures

    Transféré par

    JacqColumna
    The document discusses Le fort fractures, which result from forces applied to the maxilla in different locations. A Le fort I fracture separates the maxilla from the pterygoid plates. A Le fort II fracture separates the maxilla and nasal complex from the orbits. A Le fort III fracture is the most severe, separating the midface from the cranial base through fractures of the zygomatic bones, orbits, and pterygoid plates. Clinical findings vary depending on the type of Le fort fracture but may include swelling, malocclusion, ecchymosis, and mobility of the maxilla.

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    sur 22

    Le fort Fractures

    PGI Columna, Jacqueline Keneth


    ANATOMY
    Cranial bones
    Facial Bones
    Midface
    Buttresses of the Face
    Vertical Buttress Horizontal Buttress

    2 Components of the
    Buttress System
    Consists of the:
    • Nasomaxillary
    • Zygomaticomaxillary
    • Pterygomaxillary
    • Vertical mandible

    Vertical Buttress
    • They resist occlusional load
    • Lateral and medial on each side
    as well as posterior
    • Lateral buttress passes from the
    molar regions superiorly along the
    zygomaticomaxillary suture,
    through the solid malar eminence,
    then up along the lateral orbital
    rim and the frontozygomatic
    suture into the frontal bone.
    • Medial buttress passes from the
    canine region superiorly along the
    solid bone that borders the
    piriform aperture, then superiorly
    along the solid frontal process of
    the maxilla into the frontal bone.

    Vertical Buttress
    Consists of the:
    • Frontal bar
    • Infraorbital rim &
    nasal bones
    • Hard palate &
    maxillary alveolus

    Horizontal Buttress
    • Serve as the
    connectors across the
    vertical buttresses.
    • Primarily important to
    the facial surgeon for
    reestablishing the
    correct facial
    architecture.

    Horizontal Buttress
    Le fort fractures
    • Results from a
    horizontal force
    delivered above the
    level of the teeth (to the
    maxilla).

    LeFort I Fracture
    • The fracture separates the maxilla from the pterygoid
    plates and nasal and zygomatic structures.

    LeFort I Fracture
    • Swelling of the upper • Malocclusion.
    lip. • Mobility of tooth
    • Soft tissue laceration. bearing portion.
    • Open mouth to • Dull sound on
    accommodate the percussion.
    displaced • Ecchymosis of the
    dentoalveolar portion. maxillary buccal
    • Epistaxis. sulcus.

    Clinical findings
    • Results from a force
    delivered at a level of
    the nasal bones in
    superior direction.

    LeFort II Fracture
    • Separation of the
    maxilla and the
    attached nasal
    complex from the
    orbital and zygomatic
    structures.

    LeFort II Fracture
    • Ballooning of the face
    • Lengthenening of the face
    • Circumorbital ecchymosis
    • Subconjunctival Haemorrhage • Malocclusion
    • Epistaxis • Gagging of the posterior teeth
    • Diplopia and anterior open bite
    • Enophthalmos • Mobility of the maxilla
    • CSF rhinorrhoea • Ecchymosis of the sulcus
    • Step deformity in the lower
    border of the orbit
    • Intact zygomatic bone and arch

    Clinical findings
    • Results when
    horizontal forces are
    applied at a level
    superior enough (at
    orbital level) to separate
    the NOE) complex, the
    zygomas, and the
    maxilla from the cranial
    base (Craniofacial
    separation/dysjunction).

    LeFort III Fracture


    • The fracture line
    courses through the
    zygomaticotemporal
    and zygomaticofrontal
    sutures  lateral orbital
    wall  inferior orbital
    fissure  medially to
    the naso-frontal suture
     fractures the
    pterygoid plate at its
    base.

    LeFort III Fracture


    • Gagging of the posterior teeth and
    anterior open bite
    • Severe edema of the face • Ecchymosis and Haemorrhage of
    “ballooning” the buccal sulcus
    • Lengthening of the face • Mobility of the maxilla
    • Flattening of the cheek • Man
    • Circumorbital ecchymosis • Obstructed airwaydibular
    • Subconjunctival Haemorrhage interference
    • Epistaxis • Bilateral circumorbital
    ecchymoses (Panda facies, or
    • Enophthalmos racoon eyes)
    • CSF rhinorrhoea • Bilateral subconjunctival
    ecchymosis
    • Diplopia

    Clinical findings

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