Document Detail

A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography.
MedLine Citation:
PMID:  12213415     Owner:  NLM     Status:  MEDLINE    
A comprehensive classification of midfacial/craniofacial fractures, based on two- and three-dimensional computed tomography (2D and 3D-CT) is presented. We performed a postmortem analysis of 24 patients who had died from trauma with signs of craniofacial fractures, based on 2D and 3D-CT studies with pathoanatomical findings. In addition, CT findings for 100 patients with craniofacial injuries requiring an emergency CT were correlated with surgical findings and follow-up results. On the basis of the analysis of a total of 377 fractures a classification system is proposed. The system is based on the use of the AO/ASIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation) scheme, defining three types (A, B, C), three groups within each type (e.g. A1, A2, A3) and three subgroups within each group (e.g. A1.1, A1.2, A1.3) with increasing severity from A1.1 (lowest) to C3.3 (highest). The craniofacial region is divided into three units: the lower midface (I), the upper midface (II) and the craniobasal-facial unit (III). Lateral and central fractures are also distinguished. Type A fractures are non-displaced fractures, type B are displaced fractures and type C are complex/defect fractures. Groups A1, B1 and C1 comprise fractures of an isolated unit; groups A2, B2 and C2, combined fractures without involvement of the skull base; and groups A3, B3 and C3 are those combined fractures with involvement of the skull base. A correlation between the severity of the fracture and (i). the number of posttraumatic functional limitations (Spearman rank test, correlation coefficient r=0.42), (ii). the need for bone grafting or dural plastic (r=0.39) and (iii). facial asymmetry (r=0.37), was observed. The proposed classification system allows standardised documentation of midfacial and craniofacial fractures, including those not precisely defined by the Le Fort classification scheme.
Carlos H Buitrago-Téllez; Wilfried Schilli; Michael Bohnert; Kurt Alt; Martin Kimmig
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Injury     Volume:  33     ISSN:  0020-1383     ISO Abbreviation:  Injury     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-05     Completed Date:  2002-11-29     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  England    
Other Details:
Languages:  eng     Pagination:  651-68     Citation Subset:  IM    
Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
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MeSH Terms
Aged, 80 and over
Facial Bones / injuries*,  radiography,  surgery
Imaging, Three-Dimensional
Middle Aged
Retrospective Studies
Skull / radiography,  surgery
Skull Fractures / classification*,  radiography,  surgery
Tomography, X-Ray Computed*

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