Facial Trauma & Injuries
How Are Maxillary Fractures Treated?
To understand maxillary fractures and their treatment you first need to understand that these regions are split into three parts: the upper maxilla, mid-maxilla, and lower maxilla. Depending on the severity and cause of the facial trauma there are three classifications for these features.
Le Fort 1 – A horizontal fracture across the inferior aspect of the Maxilla, often extending through the lower nasal septum. This may be the result of a direct blow on the maxillary rim in a downward direction.
Le Fort 2 – A pyramid-shaped fracture caused by a blow to the lower or mid maxilla, which extends from the nasal bridge through the frontal maxilla. This may cause facial swelling, epistaxis, and a sub-conjuctival hemorrhage.
Le Fort 3 – A transverse fracture, also known as craniofacial disjunction, which is the result of a blow to the nasal bridge or upper maxilla, and causes separation of the facial bones from the cranial base.
One of the top concerns related to this facial trauma is the possibility of closed airways. generally, there is an immediate need to ensure that air passages are open. Any facial features that threaten airways will be moved back into place, which both opens airways and reduces bleeding. Treatment goals include repairing the bone’s natural bone architecture in order to avoid leaving any signs of the injury.
We can treat soft tissue with surgical sutures. We treat bone fractures based upon the location of the fracture, the extent of the fracture and the general health of the patient. Since it is not possible to stabilize facial fractures with casts we’ll use wires, plates, and/or screws instead.
The patient may also have to wear dental braces. We try to retain as much of the patient’s facial appearance as possible.
Finally, using advanced techniques we can now use microplates and resorbable plates to treat facial fractures. Injuries to the teeth may require the teamwork of several dental specialists, depending on the injury.