Le fort i and ii, nasal bone and sagittal maxillary fractures are differentiated. Fracture coding, imaging, and topographical distribution according to the general scheme of the aoota classi. Part ii of a 2 part presentation on midface fractures. A prospective study on midface fractures was carried out in the department of oral and maxillofacial surgery at college of dentistry, indore, from august 2007 to september 2009 to analyze etiology, incidence and patterns of midface fractures and associated ocular injuries. Fractures of the midfacial bones are most commonly due to blunt trauma. Wed like to understand how you use our websites in order to improve them. Complex midfacial fractures consist of multiple facial fractures that cannot be classified as any of the defined complex facial fracture e. Ct, even minor, clinically irrelevant fractures of the facial skeleton can be visualized. Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socioeconomic impact. Diagnosis and treatment of midface fractures pocket.
The management of midfacial fractures includes the treatment of facial fractures, dentoalveolar trauma. Le fort classification of midface fractures can be used to describe midface fractures. Fractures of the midfaceorthodontic courses by indian dental. Etiology, incidence and patterns of midface fractures and. Facial fractures made easy edited by arjun shenoy himanshu soni. Iii midface fracture, parasagittal palatal fracture and triple mandibular fracture. All fractures, from the simple to the most complex, are covered. Midface fractures level 2 tutorial article pdf available in craniomaxillofacial trauma and reconstruction 7suppl 1. Complex midfacial fracture radiology reference article. Facial fractures in pediatric patients do not follow the le fort pattern, but have oblique fracture lines. The mandible is most often broken as a result of blunt trauma, such as being punched or hit with a baseball bat or other object. Fractures of the jaw and midface msd manual consumer version. The facial skeleton is made up of thin segments of bone encased and supported by a more rigid framework of buttresses. Fractures of the upper jaw part of the bone called the maxilla are sometimes called jaw fractures but are usually considered facial fractures.
A n 89yearold man presented to the ed with facial trauma due to a mechanical fall after losing his balance on uneven pavement and hitting the right side of his face. The primary treatment of frontobasal and midfacial fractures in patients with head injuries. Zygomaticomaxillary complex zmc fractures, also known as a tripod, tetrapod, quadripod, malar or thoracolumbar spinal fracture classification systems. In addition, most midface fractures have some degree of comminution and are complicated by fractures and displacement not addressed in the lefort system. This article aims to analyze the changing le fort fracture patterns using computed tomography ct scans with threedimensional 3d reconstruction. Pattern of fractures in nonaccidental injuries in the pediatric population in singapore. Free ebook download facial fractures made easy volume1. Portable document format pdf, suitable for downloading to a smart. Computed tomography ct has become the imaging standard of reference in evaluating these injuries to determine which patients will require surgical intervention for their bony injuries, 3, 4. Distribution of fractures, cause of injury, associated. Midfacial fracture definition of midfacial fracture by. Analysis of the changing patterns of midface fractures using. A total of 550 midface fractures were studied for their midface components and the presence of fractures in the adjacent frontal bone or mandible. Incidence and etiology of unplanned cast changes for fractures in the pediatric population.
Two hundred patients were included in this study, amongst those who reported to the department of omfs, college of. A retrospective 4year study of 225 patients who collectively suffered 356 midfacial fractures is presented. Pdf authors report their experience in the treatment of midfacial fractures in 201 patients, 177 of whom underwent surgery for. However, if the maxilla has been displaced the following can be described. Thirtyfour percent of the study patients 30% of the patients with zmc fractures and 44% of the patients with midface fractures underwent orbital rim exposure and orbital floor exploration as part of their fracture management. Any information contained in this pdf file is automatically generated from digital material. Musculoskeletal s tructures and f unction the s keletal s tructures modern orthopaedics is concerned with the diagnosis and management of disorders of the musculoskeletal system, that is the skeleton and. It serves an important role in vocal resonance within the sinuses of the facial bones as well as in the function of the ocular, olfactory, respiratory, and digestive systems. Patient demographics, mechanism of injury, fracture location, modality of imaging and treatment were recorded. The fractures of midface are generally comminuted esp bones of nasoethmoid and anterior maxilla creating typical dish face deformity. Criteria for selective management of the orbital rim and. The midface is important functionally and cosmetically. Le fort fracture, zygomaticomaxillary complex fracture, nasoorbitalethmoid fracture.
Cmtr91003 body fracture traversing anterior transition zone. The purpose of this article is to describe the major fracture patterns of the midface buttresses and their surgical relevance. Condyle fractures are the injuries that most require hospitalization and treatment. Pdf fractures of the midface pose a serious medical problem as for their complexity, frequency and their socioeconomic impact. Hard and soft tissue volume changes may further compromise midface fracture repair, irrespective of the quality of the surgical outcome. Midface fractures part ii free download as powerpoint presentation. Disturbances of smell and taste after high central midface fractures. An overview 1gk thapliyal, 2h ranga rajan abstract trauma to the midface involves fracture of the maxilla, the zygoma, orbit and the nasoorbital ethmoid complex. Midface fractures are therefore classified according to their general position.
Midface fractures part ii oral and maxillofacial surgery. Jun 03, 2016 the lefort fracture system is deficient in addressing most midface fractures because they do not follow the simple lefort pattern of fracture but, rather, assume a combination of lefort fractures. Factors affecting bone mineral mass loss after lowerlimb fractures in a pediatric population. The resulting fractures may be asymmetric from one side of the face to the other i.
Midface fractures are common sequelae of motor vehicle accidents, falls, assaults, and other blunt trauma, 1, 2. Miniplates and screws these are monocortical, semirigid fixation device which provide 3d stability. The patterns of midface fractures were related to postoperative computed tomography scans and clinical results to assess the value of ordering fracture assembly in success of treatment methods. Fractures of the midface, which includes the area from the superior orbital rim to the maxillary teeth, can cause irregularity in the smooth contour of the cheeks, malar eminences, zygomatic arch, or orbital rims. A retrospective study of 356 midfacial fractures occurring in 225.
The atlas format of craniomaxiollofacial fracturesclearly shows how to manage fractures to the head, face and jaw bones with rigid internal fixation. Sixtysix percent of these patients 70% of the patients with zmc fractures and 56% of the patients with. A lefort 1 fracture is also known as a guerin fracture. Lefort ii fracturesinvolve seperation of the nasofrontal suture anteriorly. The aocmf classification group developed a hierarchical threelevel craniomaxillofacial classification system with increasing level of complexity and details. Resident manual of trauma to the face, head, and neck aaohns. There are no clear, evidencebased guidelines that dictate when it is safe for a patient to fly after sustaining a midface fracture. The indian dental academy is the leader in continuing dental education, training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Tend to present greenstick fractures for the incomplete ossification. The forces from below upwards are well tolerated and distributed along the buttresses of the face but lateral and horizontal forces invariably leads to fracture of maxilla. The face is also fundamental to interpersonal recognition and the perception of selfimage. The surgical treatment of displaced craniofacial fractures centers. Patients with midface fractures are often examined. From january 2006 to december 2009, the royal darwin hospital maxillofacial unit had 48 out of 201 patients with an orbital fracture that involved a paranasal air sinus transported by a variety of aircraft to the unit for definitive management. Craniomaxillofacial fractures download ebook pdf, epub. Mgt of midface fractures human head and neck human.
Australia, maxillofacial fractures are the third most common trauma in falls in the. May 21, 2016 such fractures permit separate mobility of the maxilla relative to the rest of the midface. Midface fractures were classified as fractures of the orbit rim, walls, floor, zygomatic arch, zygomaticomaxillary complex zmc, nasoorbitoethmoidal noe complex, and le fort 1, 2, 3 type pattern fractures. What is mid face area between a superior plane drawn through the zygomaticofrontal sutures tangential to the base of the skull and an inferior plane at the level of the maxillary dental occlusal surfaces these planes do not parallel each other but converge posteriorly at a level approximating that of the foramen magnum triangular region with. Because most midfacial fractures are not definitely. Ultralowdose computed tomography imaging for surgery of midfacial and orbital fractures using asir and mbir. In complex midface injuries with multiple fractures, it is important to distinguish those that have direct surgical relevance 6. Fractures may be due to pathology, direct violence, indirect violence, or muscular contraction.1192 211 929 1247 598 180 1520 595 1156 111 248 661 183 1498 828 882 1197 422 454 1666 773 197 1182 518 1516 620 1650 374 462 811 978 988 784 985 1060 948 1269