Le Fort Fracture I
I’m Ed Smith, a Sacramento Bone Fracture Lawyer. It is not unusual for people to sustain facial fractures in car accidents. A Le Fort Fracture Type I is a part of the LeFort facial fracture group that can occur in car accidents.
What is a LeFort Fracture Type I?
A Le Fort Fracture Type I can cause an injury known as a “floating palate.” This occurs due to injury to the following bones:
- The pterygoid plate (involved in ALL Le Fort fractures)
- The alveolar rim
- The maxillary sinus
- The nasal cavity
If all of these bones are broken, the upper palate is free to “float” around, causing serious complications that could require emergent attention.
How Does this Fracture Develop?
A Le Fort Fracture Type I develops when a force is directed towards the alveolar rim or maxillary sinus from above in a downwards trajectory. If the car rolls, the windshield can become free and strike the driver or the passenger. If it catches the maxillary sinus or alveolar rim, the severe force associated with the car accident can be enough to cause one or more of the bones above to break.
What are the Options for Treatment?
A Le Fort Fracture Type I will vary in severity based on the number of bones broken and how badly they are displaced. This fracture class almost universally requires treatment; however, many times the surgeon will try to wait until the swelling subsides. This will allow a clear surgical field for operation. If the patient is hemorrhaging or has a compromised airway, this might not be an option. Emergency surgery will be required for these patients.
A Le Fort Fracture Type I can have Grave Complications
A Le Fort Fracture Type I has a handful of very serious complications that people should keep in mind.
Infection: The human mouth is home to countless types of bacteria that are normally contained within the oral cavity. If the palate is free from its connections, the barrier is broken. Bacteria can traverse from the mouth or the nose into the soft tissues of the face and cause serious complications.
Airway Compromise: Understandably, if the upper palate is free to “float” around, it can quickly obstruct the airway and cause emergent surgery. It is vital that everyone understands that a floating palate can cause severe trouble with breathing and cause serious complications. This is in addition to the severe bleeding that can develop.
What Other Structures are at Risk?
While a Le Fort Fracture Type I can cause serious damage to the nose and mouth, there are other structures that are placed at risk. The teeth attached to the palate can become chipped or damaged in the process. This can make it challenging to approximate the jaw during surgery. There are also important nerves, such as the second branch of the Trigeminal nerve, that can become damaged during the fracture. This nerve provides sensation to the maxillary region of the face.
What else is on the Differential Diagnosis?
The LeFort Fracture Type I has a specific set of criteria that are met for diagnosis. With this in mind, several other fractures with slightly different criteria are on the differential:
- Le Fort Fracture Type II
- Le Fort Fracture Type III
- Mandibular fracture
- Maxillary fracture
What is the prognosis of this injury?
Almost every Le Fort Fracture Type I will require surgery to fix. The surgeon will use wires, plates, and screws to put the face back together in a way that maximizes functionality and aesthetics; however, this could require multiple operations to finalize. The patient will likely need to learn how to eat again since the teeth will likely line up slightly differently. Most patients make a full recovery; however, any facial nerve damage is permanent.
What are the Indications for Surgery?
The Le Fort Fracture Type I almost universally requires surgery to fix. The bones are out of position, especially if they are “floating,” and must be approximated to facilitate healing. This surgery is sometimes emergent if there is hemorrhage or airway compromise, but most surgeons will prefer to wait until the swelling reduces.
Related Articles by Ed Smith ~
- Facial Fractures & Auto Accidents
- Cranial & Facial Fractures
- Concomitant Injuries to Facial Fractures
Sacramento Facial Fracture Injury Attorneys
I’m Ed Smith, a Sacramento Bone Fracture Injury Attorney. If you or someone that you love has been seriously injured due to the negligent act of someone else, please call me at (916) 921-6400 for free, friendly advice. Elsewhere, dial me toll free at (800) 404-5400.
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