A.

Classification of Maxillary Fracture :

1. A LeFort 1 fracture is a horizontal fracture that separates the palate and upper alveolar
ridge from therest of the face.

Signs and Simptoms Lefort I :

1. Mobility of whole of tooth bearing segment of upper jaw

2. Disturbed occlusion
3. Palpable crepitation in upper buccal sulcus
4. ‘Cracked pot’ percussion note from upper teeth
5. Haematoma intra-orally over root of zygoma
6. Haematoma in palate
7. Fractured cusps of cheek teeth
8. Bruising of upper lip and lower half of mid-face

2. A LeFort II fracture line separates the maxilla and the medial orbit from the zygomatic
archand the skull.

Signs and Simptoms Lefort II

1. Mobile maxilla
2. Gagging on posterior teeth
3. Anterior open bite
4. Periorbital echymosis/haematoma
5. Nose included or separate
6. Eyes – diplopia, subconjunctival haemorrhage
7. Steps – zygomatic buttress, infraorbital margin
8. Infra-orbital nerve damage

3. A LeFort III fracture line extends through the lateral orbit, the zygomatic arch and the
pterygoid plate, separating the midfacial structures from the cranium. The mid-face
skeleton is completely detached from the base of the skull and suspended only by soft
tissues and characterized by “dish face” deformity. LeFort IIand III fractures are
frequently associated with basilar skull fractures and dural tears, and the cribriform
plateis usually also damaged. A maxillofacial fracture that extends into the frontal bones
is frequently referred to as a LeFort IV fracture, with clinical conditions similar to the
LeFort III injuries.

Signs and Simptoms Lefort III :

1. Mobile middle third of face

 2. Gagging on posterior teeth
3. Anterior open bite
4. Periorbital ecchymosis/haematoma
5. Nose included or separate
6. Eyes – diplopia, subconjunctival haemorrhage
7. Steps – zygomatic buttress, infraorbital margin
8. Infraorbital nerve damage
9. Separation at F-Z suture
10. CSF Rhinorrhea

Figure 2. Classification of LeFort fractures

Complication :

Likely complications associated with maxillofacial and upper airway injuries are

• Airway compromise

• Haemorrhage

• Trismus

• Cervical spine injury

• Pneumoencephalus
• Injury to oesophagus

• Subcutaneous emphysema and pneumomediastinum