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.