Saturday, 18 December 2010

Maxillary Fractures :Physical Examination

Le Fort I fractures: Physical findings include facial edema and mobility of the hard palate. This is evaluated by grasping the incisors and hard palate and gently pushing in and out.

Le Fort II fractures: Findings include marked facial edema with telecanthus, bilateral subconjunctival hemorrhages, and mobility of the maxilla. Epistaxis or CSF rhinorrhea may be noted.

Le Fort III fractures: Findings include the appearance of facial elongation and flattening (ie, dishface deformity). Maxilla often is displaced posteriorly, causing an anterior open bite. Grasping the teeth and hard palate and gently moving them results in movement of all facial bones in relation to the cranium. CSF rhinorrhea is almost always present but may be obscured by epistaxis.

In some instances, maxillary fractures are a combination of two or three Le Fort types. Although this system of classification is considered somewhat simplistic

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