Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- Typically blunt trauma from motor vehicle accidents, direct blows including assaults, or falls.
- Consider physical assault and domestic violence, especially in women and children.
- Open fractures common.
- Many facial fractures are complex and are not easily classified.
- Le Fort fractures involve the maxilla and are classified as:
- Le Fort I: Transverse fracture of maxilla below nose but above teeth through lateral wall of maxillary sinus to lateral pterygoid plate.
- Le Fort II: Pyramidal fracture from nasal and ethmoid bones through zygomaticomaxillary suture and maxilla, often involving maxillary sinuses and infraorbital rims.
- Le Fort III: Craniofacial disjunction with elongated, flattened face owing to fractures through frontozygomatic suture, orbit, base of nose, and ethmoid bone.
- Le Fort IV: Includes frontal bone in addition to Le Fort III.
- A patient may have different level Le Fort fractures on each side of the face.
- Zygomatic arch fractures often occur in 2 or 3 places and can involve the orbit and maxilla (tripod fracture).
- Inner plate frontal sinus fractures are associated with CSF leaks and ocular injuries.
- Orbital fractures most commonly involve the orbital floor (blow-out fracture), and are commonly associated with ocular injuries but can involve the medial and lateral orbital walls.
- Falls most common cause.
- Zygoma most common bone fractured.
- Beware of associated cervical and intracranial injuries.
- Maxillofacial fractures rarely seen in children younger than 6 yr; suspect nonaccidental trauma.
- Falls and motor vehicle accidents account for most cases.
- Over 50% have severe associated injuries, high incidence of associated head injury.
- Fractures of the orbit are the most common facial fracture in children (excluding nose)