Beyond age 70, facial injuries were more common in women. When sub-analyzed by decade of life, men were found to have a higher incidence of facial fracture each decade through age 70. Several studies have indicated a higher incidence of facial fractures in men relative to women, with ratio of 2.0-2.8:1. In contrast, MVAs appear to be the leading cause of midface fractures in developing nations. found the most common etiology of both midface and maxillary fractures to be assault (39.7%), followed by falls (27.9%) and MVAs (27.2%). Several studies have identified assault as the leading cause of midface fractures in developed countries. It has also been proposed that more aggressive interpersonal conflict has resulted in an increase in rate of head and face trauma. Increased urbanization with higher road density and faster and multiple vehicular traffic has resulted in an increased incidence of MVAs while improved vehicular safety has resulted in lower mortality with higher morbidity. Incidence of maxillofacial trauma has increased globally over the last several decades, believed to be in part due to complex social and societal factors. Frequently asymmetrical and incompletely, Le Fort II and Le Fort III fractures involve the orbit with ophthalmological consequences while Le Fort I typically does not. Le Fort fractures describe facial fracture patterns secondary to blunt force trauma that involve the pterygoid plate, which can result in separation of the facial skeleton from the skull base. More recently, an adaptation of Le Fort fractures has been included in the Practical Classification of Orbital & Orbitofacial fractures (Orbital Fractures: Principles, Concepts & Management. These four categories include a high horizontal fracture (which includes LeFort II and LeFort III), low horizontal fracture (includes LeFort I), sagittal fracture (includes midline and paramidline fractures), and alveolar fracture. More recent literature suggests a revised classification scheme with four categories would be a more accurate description of midfacial fractures. Although modern technology and imaging modalities have identified fractures that do not fall precisely into the Le Fort classification scheme, this terminology is still routinely used to summarize and communicate midface injuries. He reportedly conducted 35 experiments and, with the resulting data, published three manuscripts in 1901 describing the fracture patterns that have come to be termed LeFort I, II, and III. Le Fort would apply varying degrees of blunt force to severed and attached cadaver heads with a wooden club, a metal shaft, and reportedly a cannon ball. His prior military career prompted Le Fort to experiment with facial trauma to better identify fracture patterns following blunt injury. Following medical school graduation at age 22, Le Fort pursued a career in military medicine before returning to his alma mater to teach. René Le Fort was a prominent French surgeon in the late 19th and early 20th century. Careful attention should be paid to evaluate for additional facial or intracranial injuries as Le Fort fractures are frequently seen in association with concomitant life threatening injuries given the mechanisms of injury and the degree of force necessary to produce these fracture patterns. Management involves surgical correction for significantly displaced fractures with clinical: function and/or esthetic consequences. However, it is not a specific finding and presence of pterygoid plate involvement does not confirm a Le Fort fracture. Significantly, a pterygoid fracture is highly sensitive for a Le Fort fracture and is present in all three fracture variations. These fractures are often present asymmetrically. Physical exam is important however, diagnosis and classification are largely dependent on radiological findings. These fractures are designated Le Fort I, Le Fort II, and Le Fort III respectively. Le Fort fractures are classified by direction of fracture pattern: horizontal, pyramidal, or transverse. Common etiologies include assault, facial trauma in contact sports, motor vehicle accidents (MVA), or falls from significant heights. Initially described in 1901 by French surgeon René Le Fort (1869-1951), LeFort fractures represent a group of midface fractures that occur following blunt trauma and follow areas of structural weakness. 5.3.2 Closed Method (less preferred in contemporary practice).5.3.1 Open Method (most commonly used today).3.5.3 Le Fort Type III (Transverse, aka Craniofacial Dysfunction).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |