![]() As a result, there is gagging on the side of injury.[ĭiagnosisA 3-D CT reconstruction showing a LeFort type 1 fracture ( fracture line is marked by an arrow )Diagnosis is suspected by physical exam and history, in which, classically, the hard and soft palate of the midface are mobile with respect to the remainder of facial structures. Guérin's sign is present characterised by ecchymosis in the region of greater palatine vessels.Le Fort II and Le Fort III (common) - Gross edema of soft tissue over the middle third of the face, bilateral circumorbital ecchymosis, bilateral subconjunctival hemorrhage, epistaxis, CSF rhinorrhoea, dish face deformity, diplopia, enophthalmos, cracked pot sound.Le Fort II - Step deformity at infraorbital margin, mobile mid face, anesthesia or paresthesia of cheek.Le Fort III - Tenderness and separation at frontozygomatic suture, lengthening of face, depression of ocular levels (enophthalmos), hooding of eyes, and tilting of occlusal plane, an imaginary curved plane between the edges of the incisors and the tips of the posterior teeth. Percussion of upper teeth results in cracked pot sound. Impacted type of fractures may be almost immobile and it is only by grasping the maxillary teeth and applying a little firm pressure that a characteristic grate can be felt which is diagnostic of the fracture. Signs and symptomsLe Fort I - Slight swelling of the upper lip, ecchymosis is present in the buccal sulcus beneath each zygomatic arch, malocclusion, mobility of teeth. The fractures are named after French surgeon René Le Fort (1869–1951), who discovered the fracture patterns by examining crush injuries in cadavers. The pterygoid plates lie posterior to the upper dental row, or alveolar ridge, when viewing the face from an anterior view. Continuity of this structure is a keystone for stability of the midface, involvement of which impacts surgical management of trauma victims, as it requires fixation to a horizontal bar of the frontal bone. The hallmark of Lefort fractures is traumatic pterygomaxillary separation, which signifies fractures between the pterygoid plates, horseshoe shaped bony protuberances which extend from the inferior margin of the maxilla, and the maxillary sinuses. Le Fort fracture of skull From Wikipedia, the free encyclopediaJump to navigationJump to searchLeFort fractureLeFort I (red), II (blue), and III (green) fracturesA Le Fort fracture of the skull is a classic transfacial fracture of the midface, involving the maxillary bone and surrounding structures in either a horizontal, pyramidal or transverse direction. ![]()
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