A LeFort fracture is a serious break along the maxilla, a large section of bone in the front of the face. The maxilla connects the base of the skull to the upper jaw and serves to protect the eye sockets, nasal cavities, and sinuses. A LeFort fracture generally requires a very large amount of force, such as the impact from a high-speed automobile crash. Patients who are diagnosed with LeFort fractures usually need surgery to reconstruct the maxilla, realign bones in the face, and repair surrounding soft tissue. Depending on the exact location and severity of a fracture, a person may need ongoing surgical care and physical therapy to correct complications.
Doctors generally recognize three general types of LeFort fracture, classified by the part of the maxilla that is broken. Type one fractures occur along the lower portion of the bone, just below the nose. Type two signifies a break behind or to the side of the bridge of the nose, and a type three fracture occurs underneath the eye sockets.
Small fractures and bone contusions along the maxilla are common consequences of fistfights, sports injuries, and falls. A true LeFort fracture, however, involves a more serious and defined break. Car accidents are by far the leading cause of LeFort fractures. A fall from a great height or blunt trauma from a heavy, hard object can also cause a severe break. Acute face injuries typically cause intense pain and swelling that may inhibit speaking, breathing, or eyesight. It is essential to contact emergency personnel when a person suffers a head injury to prevent coma, shock, and other life-threatening complications.
In an emergency room, a patient with a suspected LeFort fracture is immediately assessed for breathing problems and blood loss. After body systems are stabilized, a specialist can take x-rays and computerized tomography scans of the head. Imaging tests show the location of the fracture, its severity, and any collateral damage to soft tissue in the face. After researching the full extent of a patient's injury, treatment decisions can be considered.
Patients who are not at risk of airway constriction or vision loss may not need surgery right away. Pain medications, antibiotics, and anti-inflammatory drugs can relieve some symptoms until an operation is scheduled. Surgical procedures are generally focused at realigning the maxilla bone and filling in any gaps with synthetic material or grafted bone tissue. Surgeons also address any damage to the eye sockets, nasal cavities, sinuses, and nerves. Recovery can take several months or years depending on the severity of a LeFort fracture, but most patients are able to eventually regain normal vision and speaking abilities.