Lefort fractures

Dr Saqba Alam

1. LEFORT FRACTURES BY Dr. SAQBA ALAM BDS,FCPS (PGr ORAL AND MAXFAX SURGERY )

2. INTRODUCTION The maxilla represents a bridge between the cranial base superiorly and dentition inferiorly.

3. Fractures of these bones is potentially life threatening and also disfiguring. Systemic and timely repair of these fractures is important to correct deformity and prevent unfavorable sequelae

4. HISTORY :-

5. “3 basic fault lines” 1901 RENE LEFORT Heads were subjected to low velocity forces ,soft tissues were then removed and fracture lines examined on 32 cadavers.

6. SURGICAL ANATOMY Lacrimal fossa is partly formed by maxilla hence fracture can cause injury to nasolacrimal duct

7. INFRAORBITAL NERVE INJURY

8. LOSS OF SENSATIONS

9. CHANGE IN OCCULAR LEVEL DUE TO SEPARATION ABOVE THE ATTACHMENT OF SUSPENSARY LIGAMENT OF LOCKWOOD.

10. ORBITAL FLOOR FRACTURES Herniation of orbital floor. Characteristic tear drop!

11. MALOCCLUSION

12. EARLY AND LATE FRACTURE COMPLICATIONS:-

13. ETIOLOGY

14. Lefort 1

15. Lefort 1

16. Lefort 1 Assessment and Examination:-

17. TREATMENT

18. Lefort 2

19. Lefort 2 fracture treatment

20. Lefort 3

21. Lefort 3 examination and assessment:-

22. Lefort 3 treatment:-

23. Signs and symptoms 1

24. Lefort 2 signs and symptoms

25. Lefort 3 signs and symptoms

26. LEFORT SYSTEM LIMITATIONS Midface fractures are now far more complex than those produced in le forts’laboratory .

27. Fractures involving cranial base and other midface configurations including severely comminuted segments are not accurately classifiable using the traditional Le fort scheme. A more precise system of describing fracture pattern is necessary to establish accurate diagnosis and determine potential surgical approaches.

28. Marciani classification

29. Conclusion:- Current management of lefort fractures include stabilization of upper midface to frontal skeleton.lower midface is stabilized to mandibular skeleton. Evaluation of pattern of fractural fragments keeping structural pillars in mind. Management should be considered in terms of functional units and horizontal and vertical buttresses.