What are the types of fracture patterns?
Here are several types of fracture patterns: Avulsion Fracture: when a fragment of bone is separated from the main mass. Buckled Fracture: (or impacted fracture), ends are driven into each other; commonly seen in arm fractures in children. Comminuted Fracture: the bone breaks into several pieces.
What is a Le Fort Type 2 fracture?
Le Fort type II fractures result from a force to lower or mid maxilla. Le Fort type III fractures are caused by impact to the nasal bridge and upper part of the maxilla Epidemiology Le Fort fractures account for 10% to 20% of all facial fractures.
What is a Type 3 fracture of the nose?
Le Fort Type III This type of fracture starts at the bridge of the nose and extends posteriorly along the medial wall of the orbit and the floor of the orbit, and then through the lateral orbital wall and the zygomatic arch. The fractures run parallel with the base of the skull, separating the entire midfacial skeleton from the cranial base.
What is a Le Fort fracture of the midface?
The midface refers to the area spanning between the outer corners of the eyes and the corners of the mouth, consisting of the nose, cheeks, and area above the upper lip. Le Fort fractures typically involve the pterygoid plates of the sphenoid bones, which form the base of the skull, extending behind the eye and below the front part of the brain.
What is a complete craniofacial separation?
A Le Fort III fracture is also called craniofacial separation because the craniofacial bone totally separates in a tripod pattern. This causes the nose and the dental arch to become mobile. The treatment of craniofacial separation (and other craniofacial injuries) is an individualised process.
What type of Le Fort injury is craniofacial dissociation?
Le Fort Type III This discontinuity between the skull and the face is termed craniofacial dissociation. This may be associated with a cerebrospinal fluid (CSF) leak.
What is a Le Fort 3 fracture?
LeFort III fractures result in craniofacial disjunction. This is the highest level LeFort fracture and essentially separates the maxilla from the skull base.
What is a Le Fort 2 fracture?
Definition. The Le Fort II fracture is also referred to as a pyramidal fracture. It commonly extends from the pterygoid plate through the maxilla, through the nasal orbital ethmoid area, and nasofrontal bone. Patients with Le Fort II injuries are often admitted to hospital unconscious and intubated.
What are the types of LeFort fractures?
LeFort fractures are classified by direction of fracture pattern: horizontal, pyramidal, or transverse. These fractures are designated LeFort I, LeFort II, and LeFort III respectively. Physical exam is important; however, diagnosis and classification are largely dependent on radiological findings.
What bones are included in a LeFort 1 fracture?
STRUCTURES INVOLVED Bones fractured in a Le Fort I fracture include the lower nasal septum, the inferior portion of the pyriform apertures, the canine fossae, both zygomaticomaxillary buttresses, the posterior maxillary walls, and the pterygoid plates.
What bones are included in a LeFort III fracture?
Le Fort fractures typically involve the pterygoid plates of the sphenoid bones, which form the base of the skull, extending behind the eye and below the front part of the brain. The pterygoid plates are projections of the sphenoid bones and connect the midface to the sphenoid bones.
What is the most common type of facial fracture?
Nasal bones (broken nose): Nasal bone fractures are the most common type of facial fracture. The nasal bone is made up of two thin bones. It takes less force to break the nasal bones than other facial bones because they are thin and prominent.
What does Le Fort mean?
Medical Definition of LeFort 1 : a fracture of the maxilla and associated bones of the midface region: a or LeFort I : a horizontal fracture of the maxilla above the apices of the teeth. b or LeFort II : a pyramid-shaped fracture of the maxilla in which the lines of fracture meet at an apex near the bridge of the nose.
What is Nasomaxillary fracture?
Nasomaxillary fractures result from an impact at a lower and more lateral site, at the junction of the nasal bone, infra-orbital rim, and nasomaxillary buttress. At this site, the thicker bone requires a higher energy trauma to fracture compared to the nasal bones.
What is Noe fracture?
Fractures of the naso-orbito-ethmoid (NOE) complex involve the bones that form the NOE confluence, including the anterior cranial fossa, the frontal bone, the bones of the ethmoid and frontal sinuses, the nasal bones, and the orbits.[1] These injuries often occur concurrent with injuries to other parts of the face and ...
What is a tripod fracture?
They are the second most common facial bone fracture after nasal bone injuries. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma.
How are the 3 different types of LeFort fractures distinguished?
The classification of Le Fort fractures is based on the plane of injury: type I is a horizontal injury, type II is a pyramidal injury, and type III is a very extensive transverse injury that often results in a craniofacial dislocation.
Which injury pattern is known as floating face?
Le Fort III FractureLe Fort III Fracture. This fracture pattern (green lines, Figure 4) describes a “floating face” with complete craniofacial disjunction resulting from fracture of the pterygoid plates, nasofrontal suture, maxillofrontal suture, orbital wall, and zygomatic arch/zygomaticofrontal suture.
Which type of fracture is most likely to cause trismus?
Zygomatic arch fractures tend to occur in 2-3 places along the arch. Often, 3 breaks occur, 1 at each end of the arch and a third in the middle, forming a V-shaped fracture; this often impinges on the temporalis muscle below, causing trismus.
What type of facial fracture is associated with the leakage of cerebrospinal fluid into the nasal sinus?
Frontal sinus fractures that extend through the posterior sinus wall can create a communication with the anterior cranial fossa resulting in leakage of cerebrospinal fluid, intracranial bleeding.
Abstract
Fractures of the craniofacial skeleton comprise variable fractures of the anterior skull base, the frontoglabellar region, the orbit, and the maxillary complex.
5.1 Frontobasal: Frontofacial Fractures
Fractures of the frontofacial level (fracture level IV) include skull base fractures in the region of the anterior cranial fossa with involvement of the neighboring aerated sinuses and fractures of the frontal and glabella regions, frequently including the orbital roof.
5.2 Midface Fractures
Midface fractures may be classified according to parameters as follows:
5.3 Craniofacial Fractures
In comparison with the past, injuries of the facial skeleton have changed considerably with reference to severity, extent, localization, and accident mechanisms, and tend toward a higher incidence of combined and severe facial and cranial injuries (Manson 1986, 1998; Gruss et al. 1989; Hardt et al. 1994; Krafft et al.
Author information
Clinic of Cranio-Maxillofacial Surgery, Luzerner Kantonsspital, Luzern, Switzerland
Editor information
Klinik für Mund- Kiefer und Gesichtschirurgie, Kantonssital Luzern, Luzern, Switzerland
What is a Le Fort fracture?
Le Fort fractures are fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. In order to be separated from the skull base, the pterygoid plates of the sphenoid bone need to be involved as these connect the midface to the sphenoid bone dorsally.
Where does a pyramidal fracture go?
pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex. fracture arch passes through the posterior alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones. uppermost fracture line can pass through the nasofrontal junction or the frontal process of the maxilla 3.
Can Le Fort fractures be unilateral?
Any combination is possible. For example, there may be type 2 on one side and contralateral type 3, or there may be unilateral type 1 and 2 fractures. It should be noted that Le Fort fractures are often associated with other facial fractures, neuromuscular injury and dental avulsions.
Who was the French surgeon who boiled the heads of cadavers?
They are named after René Le Fort , French surgeon (1869-1951). Le Fort conducted experiments on 35 cadavers inflicting varying facial trauma by dropping cannon balls and striking them with a bat. He would then boil the heads to remove soft tissue and record the results 4,5.
Is Le Fort III a transverse fracture?
Le Fort III is a floating face (transverse) Any combination is possible. For example, there may be type 2 on one side and contralateral type 3, or there may be unilateral type 1 and 2 fractures.
What is a fracture when a fragment of bone is separated from the main mass?
Avulsion Fracture: when a fragment of bone is separated from the main mass. Buckled Fracture: (or impacted fracture), ends are driven into each other; commonly seen in arm fractures in children. Comminuted Fracture: the bone breaks into several pieces.
What is a compression fracture?
Compression or Wedge Fracture: usually involves the bones in the back (vertebrae). Greenstick Fracture: an incomplete fracture in which the bone is bent; occurs most often in children. Linear Fracture: the break is parallel to the bone’s long axis. Oblique Fracture: the break has a curved or sloped pattern.
How many bones do you break in your lifetime?
Fracture Care On average every person will break at least two bones during their lifetime. That’s why we offer the area’s best fracture care to patients of all ages.
What is a transverse fracture?
Transverse Fracture: the broken piece of bone is at a right angle to the bone’s axis.
What is a non-displaced fracture?
Non-Displaced Fracture: the bone breaks but does not move out of alignment. Closed Fracture: the skin is not broken. Open Fracture: the bone has broken through the skin – this is a medical emergency and you should be seen in the emergency or urgent care department immediately.
Which fracture is parallel to the bone's long axis?
Linear Fracture: the break is parallel to the bone’s long axis.
Can you have a fractured bone treated without surgery?
We treat all types of fractures at Southwest Health, throughout all stages of the healing process. Some fractures may require surgery to align the bones and to promote better long term function, but most can be treated without surgery.
What is the midface of the skull?
The midface refers to the area spanning between the outer corners of the eyes and the corners of the mouth, consisting of the nose, cheeks, and area above the upper lip. Le Fort fractures typically involve the pterygoid plates of the sphenoid bones, which form the base of the skull, extending behind the eye and below the front part of the brain.
What is the name of the fracture that affects the midface of the skull?
Le Fort fractures, also known as midaxillary fractures, are a group of fractures that affect the midface of the skull and collectively involve a partial or complete separation of the midface from the skull.
What is a type 1 fracture?
Type I fractures typically present with slight swelling of the upper lip, bruising in the buccal surface (adjacent to the gums inside the mouth), imperfect positioning of the teeth (malocclusion), and loosening of the teeth.
What causes a Le Fort fracture?
Le Fort fractures are typically the result of forceful impact to the face. They are often caused by rapid deceleration car crashes in which the midface strikes a stationary object, such as the car’s dashboard. It can also occur if the midface is struck by a rigid object, such as a baseball bat. If the force is directed at the midface straight on, a Le Fort type I or II typically results. If the force is directed downward, a type III typically results.
What is Le Fort type II?
Le Fort type II presents with a pyramidal-shaped fracture. The upper teeth make up the base and the nasofrontal suture— a band of tissue connecting the frontal bone and the nasal bones —makes up the point or apex of the pyramidal fracture. The pyramidal plane of fracture can again occur through the alveolar ridge (an extension of the upper jaw) ...
How to treat a Le Fort fracture?
Treatment of a Le Fort fracture usually requires prompt stabilization of the fracture followed by surgery, in order to restore the typical facial orientation, re-establish proper positioning of the teeth, restore involved sinus cavities, and reunify the nose and eye socket.
What is the plane of injury in Le Fort?
There are three types of Le Fort fractures that can be classified according to the specific plane of injury. In a Le Fort type I, the plane of injury is horizontal and typically results in a separation of the teeth from the upper face.
Where does the fracture line go in a cranial fracture?
Also called cranial-facial separation, the fracture line in this injury passes from the nasofrontal area across the medial, posterior, and lateral orbital walls, the zygomatic arch, and through the upper portion of pterygoid plates.
What causes a trans-maxillary fracture?
These fractures (trans-maxillary fracture) result from a force directed low on the maxillary rim in a downward direction. This occurs in the horizontal plane at the level of the base of the nose. A direct blow to the lower face causes fractures that involve all 3 walls of the maxillary sinus and pterygoid processes. The fracture extends around both maxillary antra, through the nasal septum and the pterygoid plates. This causes palate-facial separation. However, this fracture does not involve the glabella or zygoma.
What is a Le Fort fracture?
Le Fort injuries are complex fractures of the midface, named after Rene Le Fort who studied cadaver skulls that were subjected to blunt force trauma. His experiments determined the areas of structural weakness of the maxilla designated as “lines of weakness” where fractures occurred. These fractures are classified into 3 distinct groups based on the direction of the fracture: horizontal, pyramidal or transverse. The pterygoid plate is involved in all types of Le Fort fractures. This may result in a pterygomaxillary separation. The absence of a pterygoid fracture rules out a Le Fort fracture. However, the presence of a pterygoid fracture does not specifically indicate whether a Le Fort fracture exists. Up to one-third of pterygoid plate fractures do not result from a Le Fort fracture pattern.[1][2][3]
What is the cause of a pyramidal fracture?
This pyramidal fracture occurs due to trauma to the midface. The fracture line begins in the region of the bridge of the nose (nasion) and extends obliquely through the medial aspect of the orbits and inferior orbital rims. It then continues posteriorly in a horizontal fashion above the hard palate to involve the pterygomaxillary buttresses, resulting in a disarticulation of the pyramid-shaped facial skeleton from the remainder of the skull. Note that the zygoma remains attached to the cranium.
What is a transverse fracture?
Transverse fracture through the maxilla above the roots of the teeth, separating teeth from the upper face. These can be unilateral or bilateral.
Where does a zygoma fracture go?
Inferolaterally, the fracture extends through the lacrimal bone and inferior orbital floor near the inferior orbital foramen and inferiorly through the anterior wall of the maxillary sinus. On the lateral aspect, it travels under the zygoma, across the pterygomaxillary fissure, and through the pterygoid plate.
How much of a fracture is Le Fort?
Le Fort fractures account for 10% to 20% of all facial fractures. These may be potentially life-threatening and disfiguring in patients in whom the injury is significant.