Sequelae of these fractures can range from minimal displacement requiring no intervention to displaced nasal deformity requiring initial reduction and possible future reconstructive surgery. Alqurainy et al, in a prospective study on orbital injury with midfacial fractures of any type, have reported that 90% of. Eight percent of midface fractures are accompanied by fractures of the palate 4. The nasomaxillary and zygomaticomaxillary buttresses. Historical treatments involved wiring fracture seg ments and inter maxillary fixation or wiring of the jaws imf into occlusion. Trauma midface fracture orbit zygomaticomaxillary complex. Management of midface injuries the midface is defined as the area between a superior plane drawn through the zygomatiocofrontal sutures tangential to the base of skull and an. Fractures and cartilage injuries sx2 lefort fracture lefort i redii blueand iii green fractures a le fort fracture of the skull is a classic transfacial fracture of the midface, involving the.
We are pleased to announce the second craniomaxillofacial ao course in austria on midface trauma and approaches to the facial sceleton. They can be satisfactorily reduced after this time but with each succeding day. Maxillofacial midface fractures neuroimaging clinics. 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. Current and evolving trends in the management of facial fractures.
Stability of midface fracture repair using absorbable. Midfacial fracture definition of midfacial fracture by. You may not embed one of our images on your web page without a link back to our site. Surgical management of facial fractures vula university of cape. Fractures of the midfaceorthodontic courses by indian. Nasal bone fractures complications nasal bone fractures are the most common fracture of the midface. Fractures involving both mandible and midface was seen in 67 patients and number of fractures in this group were 172. Weberferguson and sublabial incisions were made and the soft tissue elevated off the midface to unveil the underlying bony skeleton. These files will have pdf in brackets along with the filesize of the download.
Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socioeconomic impact. To develop objective criteria with which to identify patients with zygomatic complex zmc or midface fractures who require a surgical exploration and treatment of the orbital. The midface relies on key vertical and horizontal buttresses for proper function and appearance. Pdf most of the documents on the racgp website are in portable document format pdf. Resident manual of trauma to the face, head, and neck aaohns. Trauma to the midface involves fracture of the maxilla, the zygoma, orbit and the nasoorbital ethmoid complex. Incidence and patterns of fractures of mandible, midface. Etiology, incidence and patterns of midface fractures and. For true le fort i fractures, one plate across the nasomaxillary or. 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. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations.
What is mid face area between a superior plane drawn through the zygomaticofrontal sutures tangential to the base of the skull and an. Criteria for selective management of the orbital rim and. Diagnosis and treatment of midface fractures pocket. Abdeljalil abouchadi, hind taoufik, oussama nacir, adil arrob. A thorough head and neck as well as facial exam is necessary to rule out an unsuspected fracture. The matrixmidface plate and screw system is optimized to achieve stable bone. Current concepts in midface fracture management semantic scholar. Midface fractures part ii oral and maxillofacial surgery.
Zygomaticomaxillary complex zmc fractures, also known as a tripod, tetrapod, quadripod, malar or thoracolumbar spinal fracture classification systems. Open reduction of the condyle was employed in five concomitant le fort and subcondylar fractures with a loss of ramus height to prevent. Fracture coding, imaging, and topographical distribution according to the general scheme of the aoota classi. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Ocular injury is present in most midfacial fractures and is common in midfacial trauma.
Part ii of a 2 part presentation on midface fractures. Our focus is on definitive surgical management of midface fractures rather than acute stabilization of the patient, but this stage of management is critical. If you would like a large, unwatermarked image for your web page or blog, please purchase the. Fractures in both medial walls, both floors, both orbital roofs, lefort i level. Midface fractures are the most common injuries, accounting for approxi mately 70% of all maxillofacial fractures, according. Complex midfacial fractures consist of multiple facial fractures that cannot be classified as any of the defined complex facial fracture e. The le fort type iii fracture pattern results from a force directed at the orbital level, resulting in a craniofacial dysjunction or separation of the entire middle third of the craniomaxillofacial skeleton from the skull base fig. The criteria for inclusion in the study were patients who had fractures of at least three of the four axial segments of the facial skeleton. Nasoorbitoethmoid noe fractures, although less common in isolation, are a frequent component of other midface fractures and can be some of the most difficult facial fracture patterns to treat.
Many fractures of the face, usually ones that result from a substantial amount of force such as a motor vehicle crash, fall into one of the following categories called the lefort. Midface trauma and approaches to the facial sceleton. The face has traditionally been divided into upper face, midface, and lower face. Fractura lefort 1 pdf one goal of treatment is to restore proper anatomic relationships. Presentation of multiple midface fractures combined with. Fractures of the midfaceorthodontic courses by indian dental academy.
In 2003, motamedi 7 reported the distribution of facial fractures as 72. References to any names, marks, products, or services of third parties or hypertext links to third. Presentations ppt, key, pdf logging in or signing up. Fractures of the midfacial bones are most commonly due to blunt trauma from falls, altercations, and motor. Le fort fracture, zygomaticomaxillary complex fracture, naso. In complex midface injuries with multiple fractures, it is important to distinguish those that have direct surgical relevance.
Transtragal incision for improved exposure of diacapitular and condylar neck fractures m. Complex midfacial fracture radiology reference article. Le fort fractures are fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. Central and lateral midface, orbital and zygoma region midface plates 0. Patients with maxillary or midface fractures may present with any or all of the signs and symptoms. Analysis of the changing patterns of midface fractures using 3d. Lateral orbital wall fractures are rare and should not be listed when part of a zygomaticomaxillary complex zmc fracture or lefort iii hemifracture. National and international speakers will present instructional. Blunt facial trauma can fracture the jaw and other bones of the midface. Fractures seen in orbital floor, roof, medial wall. Independent from the severity and the fracture type, the basis of successful therapy of midfacial fractures is the restoration of the supporting pillar.
The le fort type ii fracture pattern results from a force delivered at the level of the nasal bone, resulting in mobility of the midface through the orbits and midfacial region. Trauma to the midface can lead to untoward complications involving critical structures of this area. With the midfacial skeleton adapted to the vertical forces of mastication, it is the force delivered at other vectors that cause the bulk of midface fractures. Le fort fractures are fractures of the midface, fractudas collectively involve separation of all or a portion of the midface from the skull base. Fractures of the zygomaticoorbital complex fractures of the zygomatic bone and arch, isolated fracture of the lateral antral wall orbital fractures fractures of the centro. Midface fractures part ii free download as powerpoint presentation. Interdisciplinary approaches and uptodate diagnostic.
Preservation of the blood supply to soft tissue and bone by careful handling and gentle reduction techniques. Midface fractures are common sequelae of motor vehicle accidents, falls, assaults, and other blunt trauma, 1, 2. Ct, even minor, clinically irrelevant fractures of the facial skeleton can be visualized. Midface fractures are common sequelae of motor vehicle accidents, falls, assaults, and other blunt trauma,1,2. Also the fractures of the midface can generally be classi. 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.