Midface Fractures
Lefort I Fracture
Transverse Maxillary
Midface Fractures
Le Fort II
•Subzygomatic pyramidal
•Gross swelling
•Immobile
•Anterior open bite
•Altered sensation
•Long faced appearance
•CSF rhinorrhoea
Midface Fractures
Lefort II Fracture
Pyramidal
Midface Fractures
Le Fort III
•Suprazygomatic craniofacial disjunction
•Gross swelling
•Immobile
•Altered occlusion with AOB
•Long faced appearance
•Flattened cheek prominence
•CSF rhinorrhoea
Midface Fractures
Lefort III Fracture
Craniofacial Disjunction
Midface Fractures
Blow Out Fractures
•Compression of orbital contents deforms the orbital
–Floor
–Walls
–Roof
•May result in
–Diplopia
–Restricted eye movements
–Enophthalmos
–Superior orbital fissure syndrome
Midface Fractures
Nasoethmoidal Injuries
•Central midface
•Traumatic telecanthus or hyperteleorism
•Nasal deformity
•Orbital wall involvement
–Enophthalmos
–Diplopia
Midface Fractures
Diagnosis of Maxillofacial Injuries
•Inspection
•Palpation
•Diagnostic Imaging
–Plain films
–CT
–Stereolithography (where available)
Midface Fractures
Midface Fractures
Inspection
Sublingual ecchymosis Step defects, ridge discontinuity, malocclusion