Copy of maxillary fracture and mid face.ppt

Describes maxillary fracture

1. Maxillofacial trauma
maxillary fractures
Mr. baha awad

2. LeFort Fractures
•Specially named facial fractures
•Usually requires significant forces
especially for LeFort II and III
–LeFort I - Maxillary fracture with “free-
floating” maxilla
–LeFort II - Maxilla, zygoma, floor of orbit and
nose
–LeFort III - Lower 2/3 of the face

3. Maxillary Fractures
•High energy injuries.
•Impact 100 times the force of gravity is
required .
•Patients often have significant multisystem
trauma.
•Classified as LeFort fractures.

4. LeFort Fractures
I II III

5. Maxillary Fractures
LeFort I
•Definition:
–Horizontal fracture of
the maxilla at the level
of the nasal fossa.
–Allows motion of the
maxilla while the nasal
bridge remains stable.

6. Maxillary Fractures
LeFort I
•Radiographic findings:
–Fracture line which
involves
•Nasal aperture
•Inferior maxilla
•Lateral wall of maxilla
•CT of the face and head
–coronal cuts
–3-D reconstruction

7. Maxillary Fractures
LeFort II
•Definition:
–Pyramidal fracture
•Maxilla
•Nasal bones
•Medial aspect of the
orbits

8. Maxillary Fractures
LeFort II
•Clinical findings:
–Marked facial edema
–Nasal flattening
–Traumatic telecanthus
–Epistaxis or CSF
rhinorrhea
–Movement of the upper
jaw and the nose

9. Maxillary Fractures
LeFort II
•Radiographic imaging:
–Fracture involves:
•Nasal bones
•Medial orbit
•Maxillary sinus
•Frontal process of the
maxilla
•CT of the face and head

10. Maxillary Fractures
LeFort III
•Definition:
–Fractures through:
•Maxilla
•Zygoma
•Nasal bones
•Ethmoid bones
•Base of the skull

11. Maxillary Fractures
LeFort III
•Clinical findings:
–Dish faced deformity
–Epistaxis and CSF
rhinorrhea
–Motion of the maxilla,
nasal bones and zygoma
–Severe airway
obstruction

12. Maxillary Fractures
LeFort III
•Radiographic imaging:
–Fractures through:
•Zygomaticfrontal suture
•Zygoma
•Medial orbital wall
•Nasal bone
•CT Face and the Head

13. Signs and Symptoms
•Often associated with orbital fractures
–risk of serious airway compromise (bleeding & edema)
–contraindication to NG tube or nasotracheal intubation
•Present with:
–Edema, Epistaxis, Numb upper teeth
–Unstable maxilla, CSF rhinorrhea
–Unusual facial appearance
•“donkey face” (lengthening)
•Panda face
•nasal flattening