Management of Le Fort II fracture accompanied with blowout fracture of orbital base: a case report

Abstract

Objective: To present a casereport of a 20 years old male with Le Fort II fracture accompanied with blowout fracture and its management. Methods: A 20 years old male patient with chief complaint of maxillary fracture and inability to chew food, also felt limitation of right eye movement and double vision was then diagnosed with Le Fort II fracture accompanied with blowout fracture of the right orbital base. The patient was rehabilitated using open reduction internal fixation of the maxilla to achieve good occlusion continue with immobilization. The orbital base fracture was rehabilitated by orbital mesh placement and release of tissue trapped inside the orbital base fracture fragments to achieve normal position and movement of the eyeball. Results: One month post-surgery follow-up showed the face was symmetrical and the enophthalmos was corrected. A good occlusion was reached. Conclusion: Proper management of Le Fort II fracture accompanied with orbital base blowout fracture can restore the function of the eye, mastication and occlusion. Symmetrical and proportional facial esthetics are among the indicators of a successful holistic maxillofacial trauma management.

Management of Multiple Maxillofacial Fracture With Mild Head Injury

“…In multiple facial trauma, anatomic reference points may be more difficult to expose and may be comminuted and therefore unable to provide proper reduction, so open reduction and internal fixation in this patients was initiated from the mandible to restore the anatomical position and supporting structures which are the key to fracture reduction. 1,6,17 The open reduction internal fixation (ORIF) procedure in this case was performed one week after the trauma, there were problems with the left maxillary comminuted fragment. Reduction of zygmoatic complex fractures becomes more difficult with time, and surgery may be delayed up to 10 days if necessary to wait for the edema to subside, making it easier to manipulate the fracture area and soft tissue.…”

“…Then, proceeding with repositioning and fixation of fracture fragments and installation of plates. 1,7,17 Management of patients with facial trauma must be comprehensive and at the same time seeking all the locations and extent of all injuries. The goal of treatment for patients with craniomaxillofacial injuries should be synergized with all injuries.…”

“…Although maxillofacial fractures rarely require immediate surgical intervention, accompanying structural brain injuries are often a surgical emergency. 1,2,3,4,5 Facial trauma often causes injury to soft tissues, teeth, bone components including mandible, maxilla, zygoma, ethmoid naso-orbital complex and supraorbital. Facial fractures vary in their severity, some involves one bone or several complex bones, depending on the force degree on the facial.…”

“…These bones are interconnected and support each other to form the skeleton of the head, so that when a fracture occurs in the midfacial area, several bones that form the cranial base, such as the sphenoid, frontal and ethmoid, are often involved. 1,2,4 Maxillofacial fractures cannot be separated from head injuries because of their adjacent location and structures. Patients of maxillofacial fractures are often accompanied by head injuries, such as intracranial hemorrhage, skull base fractures and decreased consciousness which can result in damage to the central nervous system.…”

Le Fort I and nasal fracture, primary reduction, and secondary revision saddle nose: A case report

“…3 The fundamental tenets governing the management of Le Fort fractures entail infection control, reduction of fracture fragments, fixation, and immobilisation. 9 For the majority of cases, irrespective of their specific type, open reduction with internal fixation is typically necessary when addressing Le Fort fractures. 8 Treatment of nasal fractures, as with any facial fractures, is predicated on the severity of the fracture, with the primary objective of restoring premorbid form and function with the least invasive method available.…”