LEFORT FRACTURES
BYDr. SAQBA ALAM BDS,FCPS (PGr ORAL AND MAXFAX SURGERY)
INTRODUCTION
The maxilla represents a
bridge between the cranial base superiorly and
dentition inferiorly.
Fractures of these bones is potentially life threatening and also disfiguring.
Systemic and timely repair of these fractures is important to correct deformity and prevent unfavorable sequelae
HISTORY :-
“3 basic fault lines” 1901 RENE LEFORT
Heads were subjected to low velocity forces ,soft tissues were then removed and fracture lines examined on 32 cadavers.
SURGICAL ANATOMY Lacrimal fossa is partly formed by
maxilla hence fracture can cause injury to nasolacrimal duct
INFRAORBITAL NERVE INJURY
LOSS OF SENSATIONS
CHANGE IN OCCULAR LEVEL DUE TO SEPARATION ABOVE THE ATTACHMENT OF SUSPENSARY LIGAMENT OF LOCKWOOD.
ORBITAL FLOOR FRACTURES Herniation of orbital floor.
Characteristic tear drop!
MALOCCLUSION
EARLY AND LATE FRACTURE COMPLICATIONS:-
ETIOLOGY
Lefort 1
Lefort 1
Lefort 1 Assessment and Examination:-
TREATMENT
Lefort 2
Lefort 2 fracture treatment
Lefort 3
Lefort 3 examination and assessment:-
Lefort 3 treatment:-
Signs and symptoms 1
Lefort 2 signs and symptoms
Lefort 3 signs and symptoms
LEFORT SYSTEM LIMITATIONS
Midface fractures are now far more complex than those produced in le forts’laboratory.
Fractures involving cranial base and other midface configurations including severely comminuted segments are not accurately classifiable using the traditional Le fort scheme.
A more precise system of describing fracture pattern is necessary to establish accurate diagnosis and determine potential surgical approaches.
Marciani classification
Conclusion:- Current management of lefort fractures
include stabilization of upper midface to frontal skeleton.lower midface is stabilized to mandibular skeleton.
Evaluation of pattern of fractural fragments keeping structural pillars in mind.
Management should be considered in terms of functional units and horizontal and vertical buttresses.