32yo M presents after fall
approximately 4 stories
onto sidewalk. +LOC.
and Back Pain.
T98 HR 110 RR 20 PO2
98% NRB BP 110/70
HEENT: instability of
edema, numbness of right
Neuro: GCS 10
Open Arrows: inf orbit fx
Star:Inferior orbit fx
Closed Arrow: no fx to ant/lat nasal
margin=no lefort I fx
Arrow: B/l pterygoid fxs
May Require early intubation
High Mechanism=risk for associated injuries
Open Reduction and Internal Fixation
Observation for Other Trauma Injuries
Nose moves with tugging motion
Nasal bridge->maxilla frontal process->lacrimal
bones/inf orbital floor->ant wall maxillary sinus>pterygoid plates
anterolateral margins of the nasal fossa=Type I
infraorbital rims are intact=Type 2 excluded
Ct Axial View
Right LeFort I
Left LeFort II
Rhea JT, Novelline RA: How to simplify the
CT diagnosis of Le Fort fractures. AJR
Moe, K. Maxillary and LeFort Fractures.
Tintanelli’s Emergency Medicine: A Comprehensive Study
Guide. Chapter 257 Maxillofacial Trauma
Akoglu, E. Heading the ball: a case of Le Fort II
fracture in football match. BMJ, 2011.