Le Fort fractures
(Redirected from LeFort Fractures)
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
- Facial pain and signs of trauma
- Facial instability
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