Document Detail


Sequencing LeFort fracture treatment (Organization of treatment for a panfacial fracture).
MedLine Citation:
PMID:  2098175     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The types of midfacial fractures and their complexity were evaluated in admissions to the Maryland Institute of Emergency Medical Service Systems (MIEMSS) during the years of 1984 to 1988. Two hundred and sixty-eight LeFort fractures were treated and followed (3.2 percent of admissions). One half (50 percent) had skull fractures and 40 patients (15 percent) had LeFort, skull and mandibular fractures. Isolated nasoethmoidal fractures were observed in 176 patients and in 107 patients (39 percent) of patients with LeFort fractures. Isolated mandibular fractures were observed in 321 patients and in 104 patients with LeFort fractures (39 percent). Eleven percent of patients had midfacial, nasoethmoidal and frontal sinus fractures. Six percent of patients had midfacial, frontal bone, frontal sinus and nasoethmoidal fractures (Cranial Base Crush Syndrome). Twenty two percent of patients had LeFort and frontal sinus fractures. Reconstruction of multiple area injuries is simplified by a highly organized treatment sequence that conceptualizes the face in two groups of two units. Each unit is divided into sections, and each section is assembled in three dimensions. Sections are integrated into units and units into a single reconstruction. Conceptually, in each unit, facial width must first be controlled by orientation from cranial base landmarks. Projection is then (and often reciprocally with width) established. Finally, facial length is set both in individual units and in the upper and lower face. Soft tissue is considered the "fourth dimension" of facial reconstruction. Bone reconstruction should be completed as early as possible to minimize soft tissue shrinkage, stiffness and scarring of soft tissues in nonantomic positions.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
K J Kelly; P N Manson; C A Vander Kolk; B L Markowitz; C M Dunham; T O Rumley; W A Crawley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  1     ISSN:  1049-2275     ISO Abbreviation:  J Craniofac Surg     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1991-08-01     Completed Date:  1991-08-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  168-78     Citation Subset:  D    
Affiliation:
Johns Hopkins Medical Institutions, Baltimore, Maryland.
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MeSH Terms
Descriptor/Qualifier:
Fracture Fixation
Humans
Jaw Fractures / therapy*
Maxillofacial Injuries / therapy*
Multiple Trauma / therapy
Patient Care Planning
Skull Fractures / therapy*
Surgery, Plastic / methods

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