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Le Fort Fractures

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https://www.readbyqxmd.com/read/29320322/multidetector-ct-of-midfacial-fractures-classification-systems-principles-of-reduction-and-common-complications
#1
David Dreizin, Arthur J Nam, Silviu C Diaconu, Mark P Bernstein, Uttam K Bodanapally, Felipe Munera
The advent of titanium hardware, which provides firm three-dimensional positional control, and the exquisite bone detail afforded by multidetector computed tomography (CT) have spurred the evolution of subunit-specific midfacial fracture management principles. The structural, diagnostic, and therapeutic complexity of the individual midfacial subunits, including the nose, the naso-orbito-ethmoidal region, the internal orbits, the zygomaticomaxillary complex, and the maxillary occlusion-bearing segment, are not adequately reflected in the Le Fort classification system, which provides only a general framework and has become less relevant in contemporary practice...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29304328/use-of-intraoperative-computed-tomography-in-craniomaxillofacial-trauma-surgery
#2
Karl Cuddy, Baber Khatib, R Bryan Bell, Allen Cheng, Ashish Patel, Melissa Amundson, Eric J Dierks
PURPOSE: The use of technology to aid in assessment, planning, and management of complex craniomaxillofacial injuries is increasingly common. Preoperative computed tomography (CT) evaluation is considered the standard of care, and intraoperative imaging is becoming increasingly accessible. Limited data exist regarding the implication of intraoperative CT on decision making in the management of all sites of facial fractures. The purposes of this study were to characterize the use of an intraoperative CT scanner for craniomaxillofacial surgery within our institution, to quantify the effect of intraoperative CT on surgical decision making, and to attempt to provide guidance on when to use this technology...
December 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29291388/how-do-le-fort-type-fractures-present-in-a-pediatric-cohort
#3
Alexandra Macmillan, Joseph Lopez, J D Luck, Muhammad Faateh, Paul Manson, Amir H Dorafshar
PURPOSE: Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. PATIENTS AND METHODS: We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010...
December 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29177168/le-fort-fractures-a-collective-review
#4
REVIEW
Bradley J Phillips, Lauren M Turco
Le Fort fractures constitute a pattern of complex facial injury that occurs secondary to blunt facial trauma.  The most common mechanisms of injury for these fractures, which are frequently associated with drug and alcohol use, include motor vehicle collisions, assault, and falls. A thorough search of the world's literature following PRISMA guidelines was conducted through PubMed and EBSCO databases. Search terms included "Le Fort fracture", "facial", "craniofacial", and "intracranial."  Articles were selected based on relevance and examined regarding etiology, epidemiology, diagnosis, treatment, complications, and outcomes in adults...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29108846/predictors-of-pediatric-blunt-cerebrovascular-injury
#5
Avery C Rossidis, Sasha J Tharakan, Sourav K Bose, Karuna V Shekdar, Michael L Nance, Thane A Blinman
BACKGROUND/PURPOSE: Blunt cerebrovascular injury (BCVI) is clinically challenging because these injuries are hard to detect and can have serious neurological consequences, and optimal screening criteria have not been established for children. This study aims to determine risk factors for BCVI in pediatric patients and to evaluate screening practices in a single institutional series. METHODS: A retrospective review of all pediatric blunt trauma patients evaluated over a 10-year period was performed...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28913295/management-of-le-fort-i-fracture
#6
REVIEW
Hak Su Kim, Seong Eun Kim, Hyun Tae Lee
Among the classification of maxillary fracture, the Le Fort classification is the best-known categorization. Le Fort (1901) completed experiments that determined the maxilla areas of structural weakness which he designated as the "lines of weakness". According to these results, there are three basic fracture line patterns (transverse, pyramidal and craniofacial disjunction). A transverse fracture is a Le Fort I fracture that is above the level of the apices of the maxillary teeth section, including the entire alveolar process of the maxilla, vault of the palate and inferior ends of the pterygoid processes in a single block from the upper craniofacial skeleton...
March 2017: Archives of craniofacial surgery
https://www.readbyqxmd.com/read/28812415/quality-of-life-after-orbito-facial-trauma
#7
Gitanjali Sharma, Apjit Kaur
In the wake of high incidence of orbito-facial trauma, there has been a growing need to assess not only the visual outcome, but also the psychological impact of the traumatic event. This is a single questionnaire based evaluation of 100 consecutive patients with orbito-facial trauma (blow-out and Le fort type II and III fractures) at six months of trauma. 84% of the patients had a NEI VFQ- 25 score of less than 50, with 49% having a score less than 25, reflecting the grim impact the trauma has on the quality of life...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28705063/postoperative-ct-of-the-midfacial-skeleton-after-trauma-review-of-normal-appearances-and-common-complications
#8
REVIEW
Michael J Reiter, Ryan B Schwope, Jared M Theler
OBJECTIVE: The objective of this article is to describe the CT appearance of the midfacial skeleton after surgical repair of posttraumatic Le Fort, nasoorbitoethmoidal (NOE), and frontal sinus fractures. Several of the more commonly encountered complications will also be described. CONCLUSION: Surgery after midfacial trauma is aimed at restoring both form and function. Knowledge of the principal tenets of Le Fort, NOE, and frontal sinus fracture repair is vital for radiologists to accurately assess the adequacy of treatment on postoperative CT and provide meaningful reports for the surgeon...
October 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28663775/a-single-center-review-of-palatal-fractures-etiology-patterns-concomitant-injuries-and-management
#9
Ian C Hoppe, Jordan N Halsey, Frank S Ciminello, Edward S Lee, Mark S Granick
Introduction: Palatal fractures are frequently associated with facial trauma and Le Fort fractures. The complex anatomy of the midfacial skeleton makes diagnosing and treating these injuries a challenge. The goal of this study was to report our experience with the presentation, concomitant injuries, and management of palatal fractures at a level I trauma center in an urban environment. Methods: Data were collected for all palatal fractures diagnosed between January 2000 and December 2012 at the University Hospital in Newark, NJ...
2017: Eplasty
https://www.readbyqxmd.com/read/28642192/applications-of-3d-orbital-computer-assisted-surgery-cas
#10
P Scolozzi
INTRODUCTION: The purpose of the present report is to describe the indications for use of 3D orbital computer-assisted surgery (CAS). PATIENTS AND METHODS: We analyzed the clinical and radiological data of all patients with orbital deformities treated using intra-operative navigation and CAD/CAM techniques at the Hôpitaux Universitaires de Genève, Switzerland, between 2009 and 2016. We recorded age and gender, orbital deformity, technical and surgical procedure and postoperative complications...
September 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28642189/how-to-produce-pre-shaped-rigid-arch-bars-using-low-cost-3d-printing-technology%C3%A2-%C3%A2-a-technical-note
#11
C Druelle, S Touzet-Roumazeille, G Raoul, J Ferri, R Nicot
Numerous oral and maxillofacial procedures in dentate patients begin with the fixation of occlusions. While several techniques exist to perform mandibulo-maxillary fixation, many surgeons use arch bars in common practice. In cases of severe craniofacial traumas or jaw malformations, such as temporomandibular joint ankylosis, it may be impossible to use rigid arch bars. This technical note reports on the development of a technique to produce pre-shaped rigid arch bars using 3D printing technology. We take the case of a patient who presents Le Fort 1, Le Fort 2 and Le Fort 3 fractures as well as a central palatine disjunction, an angular mandibular fracture and bilateral zygomatic fractures...
September 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28493922/comparison-of-the-long-term-clinical-performance-of-a-biodegradable-and-a-titanium-fixation-system-in-maxillofacial-surgery-a-multicenter-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
B Gareb, N B van Bakelen, G J Buijs, J Jansma, J G A M de Visscher, Th J M Hoppenreijs, J E Bergsma, B van Minnen, B Stegenga, R R M Bos
BACKGROUND: Biodegradable fixation systems could reduce or eliminate problems associated with titanium removal of implants in a second operation. AIM: The aim of this study was to compare the long-term (i.e. >5 years postoperatively) clinical performance of a titanium and a biodegradable system in oral and maxillofacial surgery. MATERIALS AND METHODS: The present multicenter Randomized Controlled Trial (RCT) was performed in four hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/28488465/surgical-management-of-lower-limb-fractures-in-patients-with-spinal-cord-injury-less-associated-with-complications-than-non-operative-management-a-retrospective-series-of-cases
#13
Alban Fouasson-Chailloux, Raphael Gross, Marc Dauty, Guillaume Gadbled, Sophie Touchais, Marc Le Fort, Brigitte Perrouin-Verbe
OBJECTIVES: To evaluate the difference in terms of overall complications between surgical and non-surgical management of lower limb fractures in patients with chronic spinal cord injury (SCI). DESIGN: A 13-year retrospective study including patients with chronic spinal cord lesion admitted for sublesional lower limb fractures. SETTING: University hospital SCI reference departments (Rehabilitation department and orthopedic department). PARTICIPANTS: Forty patients with SCI were included, 24 men and 16 women...
May 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28399616/orthodontic-surgical-treatment-and-respiratory-function-rhinomanometric-assessment
#14
Guido Galbiati, Cinzia Maspero, Lucia Giannini, Guia C Guenza, Federica Zanoni, Giampietro Farronato
BACKGROUND: Several correlations between morphological and/or positional alterations of the jaws and respiratory functional impairments have been reported. Nasal airway obstruction represents a critical issue with no clearly defined gold standard as for its measurement. Rhinomanometry was adopted by multiple Authors to evaluate whether patients with malocclusion developed respiratory functional changes after an orthodontic-surgical treatment. However, there are contrasting findings in the literature regarding the possibility of improving the respiratory function by means of surgically-assisted rapid palatal expansion (SARPE) or bimaxillary repositioning of the bony bases...
June 2017: Minerva Stomatologica
https://www.readbyqxmd.com/read/28392948/advanced-implant-prosthetic-rehabilitation-how-to-obtain-a-correct-restoration-of-both-functions-and-aesthetics-in-patients-with-complex-combined-dental-and-maxillofacial-trauma-a-case-report-and-topical-review-of-the-literature
#15
M M Figliuzzi, A Giudice, L Fortunato
Aim. This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma. Material and Methods. A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A "Le Fort" type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis...
2017: Case Reports in Dentistry
https://www.readbyqxmd.com/read/28382185/isolated-fracture-of-lateral-pterygoid-plate-by-penetrating-foreign-body-a-rarity-indeed
#16
Mukesh Surya, Pawan Soni, Ramesh Bharti, Ira Jamwal
BACKGROUND: Fractures of mid-face were first described by Le Fort and are classified into three categories - Le Fort I, Le Fort II and Le Fort III. The pterygoid processes of the sphenoid bone are fractured in all the three categories of Le Fort fractures as the sphenoid bone connects the cranium vault to the facial bones. Fractures of the pterygoid processes without associated Le Fort fractures are rare and are usually associated with fractures of the mandible, temporal bone or other facial bones...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28258969/association-between-regional-heterogeneity-in-the-mid-facial-bone-micro-architecture-and-increased-fragility-along-le-fort-lines
#17
Aleksa Janovic, Petar Milovanovic, Michael Hahn, Zoran Rakocevic, Michael Amling, Bjoern Busse, Milovan Dimitrijevic, Marija Djuric
BACKGROUND/AIM: Le Fort lines have traditionally been considered as zones of weakness in the mid-facial skeleton although the structural basis of increased bone fragility at these sites has not yet been investigated. Considering recent findings of occlusal loading-related regional heterogeneity in the mid-facial bone micro-architecture, the aim of this study was to explore whether such heterogeneity in cortical and cancellous bone micro-architecture may contribute to increased fragility at Le Fort fracture sites...
March 4, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28195897/base-of-skull-blocks-for-open-reduction-and-internal-fixation-of-faciomaxillary-fractures
#18
Sandeep Mehrotra, Sunil Anand
INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28089389/three-dimensional-finite-element-model-to-predict-patterns-of-pterygomaxillary-dysjunction-during-le-fort-i-osteotomy
#19
H Fujii, N Kuroyanagi, T Kanazawa, S Yamamoto, H Miyachi, K Shimozato
The aim of this study was to determine whether non-linear three-dimensional finite element analysis (3D-FEA) can be applied to simulate pterygomaxillary dysjunction during Le Fort I osteotomy (LFI) not involving a curved osteotome (LFI-non-COSep), and to predict potential changes in the fracture pattern associated with extending the cutting line. Computed tomography (CT) image data (100 snapshots) after LFI were converted to 3D-CT images. 3D-FEA models were built using preoperative CT matrix data and used to simulate pterygomaxillary dysjunction...
January 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27986471/retrospective-clinical-study-of-maxillary-sagittal-fractures-predictors-of-postoperative-outcome
#20
Krishna Prasad Regmi, JunBo Tu, SuMeng Ge, ChengQun Hou, XiaoYi Hu, ShiXian Li, JingTing Du
PURPOSE: Because of less attention to the sagittal component of maxillary fractures, these fractures are often misdiagnosed or the reduction is missed leading to maxillary transverse discrepancies. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures. MATERIALS AND METHODS: This study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures treated at the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xi'an Jiaotong University (Xi'an, China) from January 2008 through December 2013...
March 2017: Journal of Oral and Maxillofacial Surgery
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