Facial Fracture Classification According to Skeletal Support Mechanisms

Donat, Terry L.; Endress, Carmen; Mathog, Robert H.

doi:10.1001/archotol.124.12.1306

Cited by 42 publications

(19 citation statements)

References 18 publications

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“…[4][5][6][7] In this retrospective case series, we describe a unique type of fracture characterized by an isolated one of the posterior maxillary wall and its association with mandibular dislocation and/or fracture. The proposed mechanism for this specific injury is also discussed.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Data regarding specific patterns and mechanisms of fracture can be helpful to the radiologist by increasing the sensitivity for detection of distributed injuries in which 1 traumatic finding leads to a focused search for related injuries. [4][5][6][7] In this retrospective case series, we describe a unique type of fracture characterized by an isolated one of the posterior maxillary wall and its association with mandibular dislocation and/or fracture. The proposed mechanism for this specific injury is also discussed.…”

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confidence: 99%

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Isolated Fractures of the Posterior Maxillary Sinus: CT Appearance and Proposed Mechanism

Simonds¹,

Whitlow²,

Chen³

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY:A heretofore unreported type of facial fracture is discussed. Twenty-two cases of posterior maxillary wall fracture are reviewed, of which 59% demonstrated concomitant mandibular fracture. The proposed mechanism for this injury is an impact from the ipsilateral mandibular coronoid process striking the posterior maxillary wall, with associated mandibular dislocation or fracture. As such, further investigation of the mandible may be warranted when this type of maxillary wall fracture is encountered to exclude concomitant injury.ABBREVIATIONS: GSW ϭ gunshot wound; MVC ϭ motor vehicle crash; TMJ ϭ temporomandibular joint H igh-resolution CT with multiplanar reformats and 3D postprocessing has become a standard part of the assessment of facial trauma because of the exquisite sensitivity of this imaging technique for fracture. Such sensitivity for fracture is particularly relevant in the setting of facial trauma, given that soft-tissue swelling can mask underlying fractures on physical examination.1,2 Accurate fracture detection and characterization are important because facial fractures can have long-term functional and/or cosmetic sequelae.3 Extensive work, therefore, has been invested in describing patterns and underlying mechanisms of facial fracture.4-7 Data regarding specific patterns and mechanisms of fracture can be helpful to the radiologist by increasing the sensitivity for detection of distributed injuries in which 1 traumatic finding leads to a focused search for related injuries. [4][5][6][7] In this retrospective case series, we describe a unique type of fracture characterized by an isolated one of the posterior maxillary wall and its association with mandibular dislocation and/or fracture. The proposed mechanism for this specific injury is also discussed. Materials and MethodsWe performed a retrospective review of the neuroradiology section case log from 2002 to 2009, searching for patients with the CT (either head or face CT) diagnosis of maxilla fracture limited to the posterior wall, including a possible associated mandibular fracture. All patients had been imaged in the setting of trauma by using single-section or multidetector CT scanners with 1, 4, 16, and 64 detectors (LightSpeed VCT; GE Healthcare, Milwaukee, Wisconsin). Axial CT images were generally obtained via the following parameters: 0.625-mm section thickness (3-mm thickness in old scanners), 1.375:1 pitch, 120 kV, 540 mA, no gantry tilt, 20 display FOVs, and a bone reconstruction algorithm. Multiplanar reconstruction was performed in most of the fractures, and 3D postprocessing was performed in recent years by using AquariusNET software (TeraRecon, San Mateo, California) to aid in the diagnosis and to exclude other fractures. All CT scans were reviewed independently by 2 neuroradiologists to determine if the patient had a fracture of the maxilla limited to the posterior wall as well as a concomitant fracture and/or dislocation of the mandible. Medical records of each patient were reviewed for clinical history and confirmation of ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Isolated Fractures of the Posterior Maxillary Sinus: CT Appearance and Proposed Mechanism

Simonds¹,

Whitlow²,

Chen³

et al. 2011

AJNR Am J Neuroradiol

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“…Radiologic visualization of the involvement of key anatomic structures is essential to classify the trauma and subsequently apply a differentiated treatment strategy. The objective of treatment is to stabilize and restore the three-dimensional facial anatomy and to provide skeletal support for the proper function of mastication and the function and appearance of the overlying facial soft tissue [2,5]. Early treatment is directed toward relief of early complications and prevention of potential secondary late complications.…”

Section: Imaging Strategymentioning

confidence: 99%

“…The LeFort classification has been modified and extended as it did not apply to the more severely comminuted and combination maxillary fractures and occlusal segment trauma [4]. In a review of 87 fractures patterns only 25 (28.7%) met the criteria of LeFort fractures, and only 11 were identified as bilateral LeFort fractures of the same level [5]. Due to the fact that the complexity and extent of fractures often extends beyond the original LeFort classification, the diagnostic evaluation and treatment strategies include the mandible, nasoethmoid and clivus, and the lateral skull base (temporal bone) as well.…”

Section: Introductionmentioning

confidence: 99%

Radiologic assessment of maxillofacial, mandibular, and skull base trauma

2005

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“…These fractures can also be subdivided into solitary and complex [32]. This classification scheme may be defined as fractures of vertical buttresses and horizontal beams [33]. When describing fractures of the face, the diagnosis is best confined to the actual anatomical structures involved.…”

Section: Complex Midfacial Fracturesmentioning

confidence: 99%

Traumatic injuries: imaging of facial injuries

Salvolini

2002

Eur Radiol

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Facial injuries are common and require radiologic evaluation to plan treatment. The role of imaging is to detect fractures, describe their morphology and topography, and evaluate adjacent soft tissue damage. Computed tomography is the imaging method of choice for an accurate diagnosis and for depicting the complex anatomic structures of the maxillo-facial region. Magnetic resonance imaging plays a limited role, mainly in the assessment of lesions of orbital soft tissues. This paper reviews the most common traumatic injuries of facial bones, paranasal sinuses, orbits and mandible.

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Facial Fracture Classification According to Skeletal Support Mechanisms

Cited by 42 publications

References 18 publications

Isolated Fractures of the Posterior Maxillary Sinus: CT Appearance and Proposed Mechanism

Isolated Fractures of the Posterior Maxillary Sinus: CT Appearance and Proposed Mechanism

Radiologic assessment of maxillofacial, mandibular, and skull base trauma

Traumatic injuries: imaging of facial injuries

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