Causes of a le fort fracture12/2/2023 ![]() On exam, the nose, infraorbital rims, and the zygoma move together with the maxilla.Head and C-spine imaging should be performed to look for concomitant injury.CSF rhinorrhea and epistaxis are likely both present.Visual acuity should be tested due to the high incidence of blindness with Le Fort III fractures.Nasotracheal intubation and NG tubes are contraindicated. Because of the involvement of the zygomatic arch, there is a risk of the temporalis muscle impingement. 4 Transverse fracture line passes through nasofrontal suture, maxillofrontal suture, orbital wall, and zygomatic arch/zygomaticofrontal suture. Airway complications are common with Le Fort III. Le Fort 3: Craniofacial disjunction or Dish face deformity.The zygoma may become completely separated in some patients. The fracture extends through the frontozygomatic suture lines, across the orbit and through the base of the nose and ethmoid region. Le Fort III fractures define craniofacial disjunction.On exam, the nasal bridge moves along with the maxilla.The patient may have epistaxis or CSF rhinorrhea.This fracture is associated with marked facial edema, bilateral subconjunctival hemorrhage, and mobility of the maxilla.Le Fort II fractures include the fracture lines of a Le Fort I fracture but now involve the bony nasal skeleton becoming a pyramidal fracture.On exam, you will feel mobility while grasping the incisors and hard palate and gently pushing in and out.Le Fort I typically presents with facial edema and mobility of the hard palate.This fracture essentially separates the maxillary teeth from the face. ![]()
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