Presentation of LeFort fracture type III

Lefort fracture typing is mainly based on the connection of the maxilla, nasal bone, zygomatic bone and other craniofacial bones of the face. Lefort fractures are classified into Lefort fracture type I, Lefort fracture type II, and Lefort fracture type III according to the location of the fracture line.The types of Lefort fractures vary, as do the patient’s manifestations, such as malocclusion and panda eye signs.1. Lefort fracture type I: Also known as a low fracture or horizontal fracture, it is mainly a fracture of the maxilla in a low position. The fracture line is at the level of the pear-shaped hole or nostril, and the upper alveolar surface affects the maxillary pterygoid suture at both sides, showing a poor bite. After the fracture, there will be damage and displacement of the anterior or posterior alveolus, poor closure of the upper and lower lip, so there will be symptoms of occlusal malfunction; 2. Lefort fracture type II: also known as median fracture or conical fracture, the fracture line is along the nasal frontal suture to both sides, across the nasal bridge, medial wall, orbital floor, zygomatic maxillary suture, and then along the maxillary lateral wall of the pterygoid process, there can be cerebrospinal fluid leakage, mainly manifested as hematoma, after the fracture damage to local blood vessels, showing hematoma and ecchymosis, which can be manifested as panda eye sign; 3. Lefort fracture type III: also known as high fracture or craniofacial separation fracture, the location is relatively high, all the way to the zygomatic arch, the fracture sex line from the nasofrontal suture to both sides across the nasal bridge, orbit, through the zygomatic-frontal suture backward to the pterygoid process, forming a craniofacial separation, often making the middle of the face concave and longer, accompanied by skull base fracture or injury to the skull and brain, there will be With skull base fracture or craniocephalic injury, more serious cerebral hemorrhage, cerebrospinal fluid leakage, as well as frontal and nasal hemorrhage symptoms, there will also be obvious cerebrospinal fluid leakage, headache symptoms, or manifest facial deformity. In the case of open wounds after fracture, more severe facial deformities may occur after healing due to scar contracture. Clinically, appropriate treatment is often performed according to different subtypes. Lefort fracture type I can usually be restored to normal position by external fixation measures, while Lefort fracture type II and Lefort fracture type III require craniotomy for repositioning and fixation treatment.