Mid face fractures and classification

 Mid face fractures classified by Le fort in 1901 as : 

◦ Le fort 1 / horizontal fracture

◦ Le fort 2 / pyramidal fracture 

◦ Le fort 3 / transverse fracture 

Lefort 1 : It runs laterally from pirifirm aperture below zygomatic buttress and then from lower third of pterygoid plates joining behind maxillary tuberosity. 

SIGNS AND SYMPTOMS: 

◦ Palatal ecchymosis or Gurein sign 

◦ deranged occlusion 

◦ bruising of buccal sulcus and upper lip 

Le fort 2 : It runs from middle of nasal bone to frontal process of maxilla and then to lacrimal bone behind lacrimal sac to medial wall of orbit, crossing infrraorbital foramen and then laterally downwards below zygomaticomaxillary suture and then to pterygoid plates 

SIGNS :

◦ anesthesia and paresthesia of cheek 

◦ deranged occlusion with retropositioned maxilla

◦ step deformity and tenderness at infraorbital margin 

Le fort 3 : It runs from frontonasal suture involving ethmoid and cribriform plate entering in to inferior orbital fissure , extending backward in to pterygomaxillary fissure and laterally across lateral wall of orbit passing through frontozygomatic suture. It is also known as craniofacial dysjunction.

SIGNS: 

◦ moonlike face 

◦ hooding of eyes 

◦ Dishface appearence 

◦ diplopia 

◦ stepdeformity at frontozygomatic suture 

◦ epistaxis

By Dr. Aleena Fatima