$injury le fort fracture$ $injury le fort fracture$

Secondary survey was completed with no other injuries outside of the head and face noted. Orogastric tube, urine catheter, emergency Focused Abdominal Sonography of Trauma (eFAST) performed (negative), Chest Xray (CXR) ordered, prophylactic dose of broad-spectrum antibiotic given, cyklokapron 1 g given, and anti-tetanus given.

$injury le fort fracture$

Furthermore, reviewing the resuscitation and stabilizing such a patient in order to do a complete secondary survey, investigations, and plan for surgery and ICU management, thereafter.

$injury le fort fracture$ $injury le fort fracture$

This case report delves into the acute management of a patient presenting with a Le Fort III fracture and multiple associated life-threatening injuries according to ATLS principles. Delayed complications are mainly due to CSF leaks and persistent epistaxis. However, the prognosis is reliant on the mechanism of injury and associated life-threatening injuries, but the mortality rate for Le Fort fractures is higher than other facial fractures. This fixation involves restoration of the facial projection, establish occlusion of teeth, and restore nasal and orbital structure. The goal of surgery is to fixate unstable fracture segments to the stable structures once the patient has been adequately resuscitated and stabilized. Imaging is vital in assessment of the extent of damage and a Computed Tomography (CT) scan with three-dimensional reconstruction is sufficient, along with CT scan of the brain, C-spine and angiogram of neck to exclude any associated injuries. The secondary survey of such patients would include evaluation of the orbits and globe once the fractures have been stabilized as best as possible with sutures and packing where necessary.Ī multidisciplinary team approach is needed in the management of Le Fort III fractures and may include trauma surgeon, maxillo-facial surgeon, Ear-Nose-Throat (ENT) surgeon, ophthalmology, plastic surgeon, and Intensive Care Unit (ICU) physician. The airway obstruction in such cases results from the multiple facial fractures with compromised anatomy and multiple sources of bleeding into the upper airway. Examination according to Advanced Trauma Life Support (ATLS) principles of primary survey to secure a definitive airway and immobilize the cervical spine (C-spine), breathing with ventilatory support, circulation support with haemorrhage control, assess disability, and lastly expose the patient in their entirety with environment control is necessary. Le Fort III fractures typically present with bilateral periorbital swelling and ecchymosis, oedematous face, enophthalmos, bilateral mastoid ecchymosis, haemo-tympanum, and possibly rhinorrhoea and otorrhoea (CSF and/or blood leakage). These fractures account for approximately 10–20% of all facial fractures with the Le Fort III category being the least common, and there is a high association of intracranial head injuries and cervical spine injuries in patients that have sustained Le Fort fractures. Le Fort fractures may be associated with other facial fractures, neuromuscular injury and dental avulsions, and Le Fort III fractures have the highest cerebrospinal fluid (CSF) leak rate. To result in separation from the skull base, the pterygoid plates of the sphenoid bone are involved as these dorsally connect the midface to the sphenoid bone. Le Fort III factures are uncommon and may also be referred to as craniofacial dys-junction/dissociation, which involve disruption of the midface and involve nasofrontal junction, bilateral frontozygomatic suture and arch fractures. This case report has been reported in line with the SCARE Criteria.

$injury le fort fracture$

Injury le fort fracture