![]() Soft tissue assessment for Battle's sign (bruising over mastoid).Palpation of orbital rim for step deformities.Soft-tissue examination for lacerations and eyelid malposition.Canthal assessment to evaluate for telecanthus.Globe position with exophthalmometry and vertical position assessment.Facial sensation/infraorbital nerve evaluation.Pupil exam for signs of an afferent pupillary defect, sphincter tear, ruptured globe, or traumatic mydriasis.Extraocular motility exam and the presence of pain or diplopia with movement.Visual acuity for signs of ocular injury such as traumatic optic neuropathy, ruptured globe, retinal edema, or retinal tear.unsurprisingly type III fractures have the highest rate of CSF leakĪ computerized tomography (CT) scan of the facial bones is often required to fully assess the extent of the injury.because of the involvement of the zygomatic arch, there is a risk of the temporalis muscle impingement.transverse fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall, and zygomatic arch / zygomaticofrontal suture.Le Fort type III (floating face (transverse)).uppermost fracture line can pass through the nasofrontal junction or the frontal process of the maxilla.fracture arch passes through the posterior alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones.pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex.Le Fort type II (floating maxilla (pyramidal)).fracture line passes through the alveolar ridge, lateral nose and inferior wall of the maxillary sinus.horizontal maxillary fracture, separating the teeth from the upper face.Le Fort type I (floating palate ( horizontal)). ![]() The commonly used classification is as follows: The Le Fort classification system attempts to distinguish according to the plane of injury In order to be separated from the skull base, the pterygoid plates of the sphenoid bone need to be involved as these connect the midface to the sphenoid bone dorsally. Fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. ![]()
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