A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography

Buitrago-Téllez, C.; Schilli, W; Bohnert, Michael; Alt, Kurt W.; Kimmig, Martin

doi:10.1016/s0020-1383(02)00119-5

Cited by 68 publications

(38 citation statements)

References 26 publications

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“…There have been several recent attempts to develop more accurate systems for the classification of facial fractures (1,4,7,8,17). For example, Catapano et al (4) developed a novel system for grading the severity of facial fractures.…”

Section: Figure 1) Anterior (A) and Lateral (B) Views Of A Le Fort I mentioning

confidence: 99%

“…These studies also fail to capture the complexity of the facial buttress system. Moreover, when the response of the complete skull to trauma has been studied, it has been to a bare skull or model, which ignores the contribution of the musculature to force distribution (14,17,18). Improved understanding of the response of the intact face to stress is required to develop a better classification system for facial fractures and to improve reconstructive techniques.…”

mentioning

confidence: 99%

“…Much has changed since Le Fort's original descriptions; most craniofacial trauma now results from high-velocity motor vehicle collisions, often involving young males (2,3,17,19). This change in trauma mechanism and velocity may explain why many fractures observed today do not fit Le Fort's classification.…”

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confidence: 99%

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The le fort system revisited: trauma velocity predicts the path of le fort i fractures through the lateral buttress

et al. 2015

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Section: Figure 1) Anterior (A) and Lateral (B) Views Of A Le Fort I mentioning

confidence: 99%

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confidence: 99%

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The le fort system revisited: trauma velocity predicts the path of le fort i fractures through the lateral buttress

et al. 2015

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“…The extent of comminuted fractures is better demonstrated on the 3D-CT, where the size, shape, and displacement of individual fragments are clearly revealed. [25][26][27][28] The combination of multislice CT and 3D volume rendering technique allowed several improvements in imaging interpretation. Absence of free paranasal sinus fluid (clear sinus sign) in facial CT is a highly reliable criterion for excluding fractures involving the paranasal sinus walls.…”

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confidence: 99%

Computed Tomography evaluation of maxillofacial injuries

Prasad

Khanal

2017

J Coll Med Sci-Nepal

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Background & Objectives:The maxillofacial r egion, a complex anatomical structure, can be evaluated by conventional (plain) films, Tomography, Multidetector Computed Tomography, Three-Dimensional Computed Tomography, Orthopantomogram and Magnetic Resonance Imaging. The study was conducted with objective of describing various forms of maxillofacial injuries, imaging features of different types of maxillofacial fractures and the advantage of using Three-Dimensional Computed Tomography reconstructed image. Materials & Methods: A hospital based cross-sectional study was conducted among 50 patients during April 2014 to September 2016 using Toshiba Aquilion Prime 160 slice Multi Detector Computed Tomography scanner. Results: The maxillofacial fractures were significantly higher in male population (88%) than female population (12 %). Road traffic accidents were the most common cause of injury others being physical assault and fall from height. It was most common in 31-40 years (26%) and 21-30 (24%) years age group. Maxillary sinus was the commonest fracture (36%) followed by nasal bone and zygomatic bone (30%), mandible and orbital bones (28%). Soft tissue swelling was the commonest associated finding. Three dimensional images (3 D) compared to the axial scans missed some fractures. However, the extension of the complex fracture lines and degree of displacement were more accurately assessed. Complex fractures found were Le fort (6%) and naso-orbito-ethmoid (4%) fractures. Conclusion: The proper evaluation of complex anatomy of the facial bones requires Multidetector Computed Tomography which offers excellent spatial resolution enabling multiplanar reformations and three dimensional reconstructions for enhanced diagnostic accuracy and surgical planning.

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“…A comprehensive classification of midfacial/craniofacial fractures, based on two-and three-dimensional computed tomography (2D and 3D-CT) was proposed by Buitrago-Té llez et al [19] The craniofacial region is divided into three units: the lower midface (I), the upper midface (II) and the craniobasalfacial unit (III). Type A fractures are non-displaced fractures, type B are displaced fractures and type C are complex/defect fractures.…”

Section: Discussionmentioning

confidence: 99%

Midfacial Fractures: A Scoring Method and Validation on 117 Patients

Zollino

Arduin

Brunelli

et al. 2007

Eur J Trauma Emerg Surg

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The midfacial region (MR) is located in the middle-third of the face, composed of several bones and surrounded by complex anatomical structures so that MR fractures (MRFs) often involve other parts of the face. A staging system for classifying MRFs is of paramount importance in order to exchange information among trauma centers. Le Fort described three lines of fractures but still there is no scoring method to stage MRFs. In this article, a classification for MRFs is proposed. It is based on Le Fort's three lines and it defines seven facial units. MRFs can be staged as follows: F in situ = a fracture line without fragment mobility (i.e. greensticked); F1 = a fracture involving one MR unit (MRU); F2 = a fracture involving two MRUs; F3 = a fracture involving three MRUs; F4 = a fracture involving four or more MRUs or neighboring anatomical regions (i.e. mandible, orbit and skull). To evaluate the suitability of the proposed classification a retrospective study on a series of 117 MRFs was performed. Age, gender, new stage, clinical diagnosis at admission, type of surgery, and outcome were considered. A good correlation between the proposed classification and the studied variables was detected. In conclusion, the proposed classification is a simple and precise method of staging MRFs. It can summarize MRFs and be used in daily practice. It is our understanding, however, that a multi-centers study should be performed before the effectiveness of the proposed classification can be clearly stated.

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A comprehensive classification of craniofacial fractures: postmortem and clinical studies with two- and three-dimensional computed tomography

Cited by 68 publications

References 26 publications

The le fort system revisited: trauma velocity predicts the path of le fort i fractures through the lateral buttress

The le fort system revisited: trauma velocity predicts the path of le fort i fractures through the lateral buttress

Computed Tomography evaluation of maxillofacial injuries

Midfacial Fractures: A Scoring Method and Validation on 117 Patients

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