Le Fort Fracture II
Did you know that facial fractures are a common occurrence in car accidents? A Le Fort Fracture Type II is one of several types of facial fractures suffered in serious motor vehicle collisions and is considered a traumatic injury.
What is a Le Fort Fracture II?
Most people will think of a Le Fort Fracture Type II as a serious broken nose. The face is made up of several bones and a type II fracture will involve several of the following bones:
- The pterygoid plate (involved in ALL Le Fort fractures)
- The maxilla
- The ethmoid
- The nasofrontal bone
If all of these bones are broken, it forms a pyramidal structure around the nose. Therefore, these fractures are also called pyramidal fractures.
What Causes this Fracture?
When a car comes to a sudden stop, the driver or passenger’s head will continue to move forward due to a lack of a seatbelt. Because the nose protrudes from the face, this is commonly the first part of the head to strike to steering wheel or dashboard. The blunt force trauma to the nasal region will cause one or more of the bones discussed above to fracture.
What are the Options for Treatment?
A Le Fort Fracture Type II can vary markedly in severity depending on the number of facial bones broken and their location. Depending on the clinical situation, some patients may require emergent surgery to stabilize the bleeding. Regardless of the clinical status, almost every patient will require surgery. The surgeon will try to wait until the swelling has reduced prior to approximating the bones.
A Le Fort Fracture Type II can have Serious Complications
There are a couple of complications that must be discussed involving this serious fracture.
Infection: Because the nasal cavity is home to multiple types of bacteria, infection is a serious risk. The bacteria can move from the nasal cavity into the soft tissue of the face through the bone fractures. These infections will require antibiotics.
Hemorrhage: Everyone is familiar with nosebleeds. Now imagine that the bones encasing the nose are completely damaged. This can lead to serious bleeding that can occlude the airway in addition to a substantial loss of blood. This could require emergent surgery and stabilization.
Teeth: It is possible the upper jaw could be destabilized. This could compromise the airway in addition to posing problems with speech and eating during the rehabilitation process.
What Other Structures are at Risk?
In addition to the major damage to the nasal cavity, a Le Fort Fracture Type II can damage some of the nerves and blood vessels in the region. The second branch of the Trigeminal nerve provides sensation to the maxillary region of the face. In addition, the facial nerve also runs nearby. These structures are placed at risk in this type of fracture.
What else is on the Differential Diagnosis?
A Le Fort Fracture Type II has a very specific definition that can sometimes be challenging to diagnose. Several other fractures are also on the differential:
- Le Fort Fracture Type I
- Le Fort Fracture Type III
- Maxillary fracture
- Mandibular fracture
It is possible for a patient to have more than one facial fracture depending on the severity of the injury.
What is the Prognosis of this Injury?
A Le Fort Fracture Type II is a very serious injury that requires a significant amount of time and surgery to heal. The surgeon will wire the bones in place with the help of plates to reconstruct the face in the best manner possible; however, it is possible that revision surgery will be needed later for aesthetic reasons. If nerves are damaged, this disability will be permanent.
What are the Indications for Surgery?
More often than not, multiple bones are broken and they are displaced or comminuted. This means the bones are not in contact with one another and therefore cannot heal properly. An open reduction, through surgery, is needed to put these bones back together. While most surgeons would prefer to wait until the swelling has reduced, it is possible the patient could have airway compromise or be hemorrhaging in a manner that requires emergent surgery.
Sacramento Facial Fracture Injury Lawyers
I’m Ed Smith, a Sacramento Bone Fracture Injury Lawyer. If you or someone you love has suffered a serious injury due to the negligence of another, please call (916) 921-6400 for free, friendly advice. Or, give me a call toll-free at (800) 404-5400.
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