The Le Fort system revisited: Trauma velocity predicts the path of Le Fort I fractures through the lateral buttress
Identifieur interne : 002541 ( Pmc/Corpus ); précédent : 002540; suivant : 002542The Le Fort system revisited: Trauma velocity predicts the path of Le Fort I fractures through the lateral buttress
Auteurs : Grayson Roumeliotis ; Romy Ahluwalia ; Thomas Jenkyn ; Arjang YazdaniSource :
- Plastic Surgery [ 2292-5503 ] ; 2015.
Abstract
Although increased understanding of, and surgical experience with, the buttress systems of the face have revealed many subtleties, the Le Fort classification system for midface fractures has been in place for more than a century. However, the most prevalent mechanisms of injury today involve high-velocity motor vehicle collisions, which explains why a significant number do not fit the original system proposed by Le Fort so many years ago. This retrospective study investigated the role of trauma velocity in the fracture patterns of 39 Le Fort I fractures.
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PubMed: 25821772
PubMed Central: 4364145
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PMC:4364145Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Le Fort system revisited: Trauma velocity predicts the path of Le Fort I fractures through the lateral buttress</title>
<author><name sortKey="Roumeliotis, Grayson" sort="Roumeliotis, Grayson" uniqKey="Roumeliotis G" first="Grayson" last="Roumeliotis">Grayson Roumeliotis</name>
<affiliation><nlm:aff id="af1-ps-23-40">The Department of Surgery, Division of Plastic Surgery, University of Ottawa, Ottawa;</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ahluwalia, Romy" sort="Ahluwalia, Romy" uniqKey="Ahluwalia R" first="Romy" last="Ahluwalia">Romy Ahluwalia</name>
<affiliation><nlm:aff id="af2-ps-23-40">Department of Surgery, Division of Plastic Surgery;</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jenkyn, Thomas" sort="Jenkyn, Thomas" uniqKey="Jenkyn T" first="Thomas" last="Jenkyn">Thomas Jenkyn</name>
<affiliation><nlm:aff id="af3-ps-23-40">The Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yazdani, Arjang" sort="Yazdani, Arjang" uniqKey="Yazdani A" first="Arjang" last="Yazdani">Arjang Yazdani</name>
<affiliation><nlm:aff id="af2-ps-23-40">Department of Surgery, Division of Plastic Surgery;</nlm:aff>
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<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364145</idno>
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<date when="2015">2015</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Le Fort system revisited: Trauma velocity predicts the path of Le Fort I fractures through the lateral buttress</title>
<author><name sortKey="Roumeliotis, Grayson" sort="Roumeliotis, Grayson" uniqKey="Roumeliotis G" first="Grayson" last="Roumeliotis">Grayson Roumeliotis</name>
<affiliation><nlm:aff id="af1-ps-23-40">The Department of Surgery, Division of Plastic Surgery, University of Ottawa, Ottawa;</nlm:aff>
</affiliation>
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<author><name sortKey="Ahluwalia, Romy" sort="Ahluwalia, Romy" uniqKey="Ahluwalia R" first="Romy" last="Ahluwalia">Romy Ahluwalia</name>
<affiliation><nlm:aff id="af2-ps-23-40">Department of Surgery, Division of Plastic Surgery;</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jenkyn, Thomas" sort="Jenkyn, Thomas" uniqKey="Jenkyn T" first="Thomas" last="Jenkyn">Thomas Jenkyn</name>
<affiliation><nlm:aff id="af3-ps-23-40">The Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Yazdani, Arjang" sort="Yazdani, Arjang" uniqKey="Yazdani A" first="Arjang" last="Yazdani">Arjang Yazdani</name>
<affiliation><nlm:aff id="af2-ps-23-40">Department of Surgery, Division of Plastic Surgery;</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Plastic Surgery</title>
<idno type="ISSN">2292-5503</idno>
<idno type="eISSN">2292-5511</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><p>Although increased understanding of, and surgical experience with, the buttress systems of the face have revealed many subtleties, the Le Fort classification system for midface fractures has been in place for more than a century. However, the most prevalent mechanisms of injury today involve high-velocity motor vehicle collisions, which explains why a significant number do not fit the original system proposed by Le Fort so many years ago. This retrospective study investigated the role of trauma velocity in the fracture patterns of 39 Le Fort I fractures.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Plast Surg (Oakv)</journal-id>
<journal-id journal-id-type="iso-abbrev">Plast Surg (Oakv)</journal-id>
<journal-id journal-id-type="publisher-id">PGI</journal-id>
<journal-title-group><journal-title>Plastic Surgery</journal-title>
</journal-title-group>
<issn pub-type="ppub">2292-5503</issn>
<issn pub-type="epub">2292-5511</issn>
<publisher><publisher-name>Pulsus Group Inc</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25821772</article-id>
<article-id pub-id-type="pmc">4364145</article-id>
<article-id pub-id-type="publisher-id">ps-23-40</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>The Le Fort system revisited: Trauma velocity predicts the path of Le Fort I fractures through the lateral buttress</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Roumeliotis</surname>
<given-names>Grayson</given-names>
</name>
<degrees>MD MSc</degrees>
<xref ref-type="aff" rid="af1-ps-23-40"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c1-ps-23-40"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ahluwalia</surname>
<given-names>Romy</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="af2-ps-23-40"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jenkyn</surname>
<given-names>Thomas</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af3-ps-23-40"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yazdani</surname>
<given-names>Arjang</given-names>
</name>
<degrees>MD FRCSC</degrees>
<xref ref-type="aff" rid="af2-ps-23-40"><sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="af1-ps-23-40"><label>1</label>
The Department of Surgery, Division of Plastic Surgery, University of Ottawa, Ottawa;</aff>
<aff id="af2-ps-23-40"><label>2</label>
Department of Surgery, Division of Plastic Surgery;</aff>
<aff id="af3-ps-23-40"><label>3</label>
The Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario</aff>
<author-notes><corresp id="c1-ps-23-40">Correspondence: Dr Grayson Roumeliotis, The Ottawa Hospital-Loeb Research Building, 725 – WM150d Parkdale Avenue, Ottawa, Ontario K1Y 4E9. Telephone 613-798-5555, e-mail <email>groumeliotis@toh.on.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Spring</season>
<year>2015</year>
</pub-date>
<volume>23</volume>
<issue>1</issue>
<fpage>40</fpage>
<lpage>42</lpage>
<permissions><copyright-statement>©2015 Canadian Society of Plastic Surgeons. All rights reserved</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract abstract-type="toc"><p>Although increased understanding of, and surgical experience with, the buttress systems of the face have revealed many subtleties, the Le Fort classification system for midface fractures has been in place for more than a century. However, the most prevalent mechanisms of injury today involve high-velocity motor vehicle collisions, which explains why a significant number do not fit the original system proposed by Le Fort so many years ago. This retrospective study investigated the role of trauma velocity in the fracture patterns of 39 Le Fort I fractures.</p>
</abstract>
<abstract><sec><title>OBJECTIVE:</title>
<p>To examine the effect of trauma velocity on the pattern of Le Fort I facial fractures.</p>
</sec>
<sec><title>METHOD:</title>
<p>A retrospective medical record review was conducted on a consecutive cohort of craniofacial traumas surgically treated by a single surgeon between 2007 and 2011 (n=150). Of these cases, 39 Le Fort fractures were identified. Patient demographic information, method of trauma and velocity of impact were reviewed for these cases. Velocity of impact was expressed categorically as either ‘high’ or ‘low’: high-velocity fractures were those caused by a fall from >1 story or a motor vehicle collision; low-velocity fractures were the result of assaults with a blunt weapon, closed fist or falls from standing height. The vertical position of each fracture was measured at its point of entry on the lateral buttress and its point of exit on the piriform aperture. To allow for comparison across individuals, values were expressed as ratios based on their location on the face relative to these landmarks. A Wilcoxon rank-sum test was used to compare the fracture heights caused by high- and low-velocity trauma.</p>
</sec>
<sec><title>RESULTS:</title>
<p>The results revealed that high-velocity traumas to the face create Le Fort I fractures at a higher point in the lateral buttress compared with low-velocity traumas. There was no difference between heights at the piriform aperture.</p>
</sec>
<sec><title>CONCLUSION:</title>
<p>High-velocity trauma resulted in higher Le Fort I fracture patterns compared with low-velocity trauma.</p>
</sec>
</abstract>
<trans-abstract xml:lang="fr"><sec><title>OBJECTIF :</title>
<p>Examiner l’effet de la vélocité du traumatisme sur le profil des fractures faciales de Le Fort I.</p>
</sec>
<sec><title>MÉTHODOLOGIE :</title>
<p>Les chercheurs ont effectué une analyse rétrospective des dossiers médicaux d’une cohorte consécutive de traumatisés craniofaciaux opérés par un même chirurgien entre 2007 et 2011 (n=150). De ce nombre, ils ont repéré 39 fractures de Le Fort. Ils ont extrait les caractéristiques démographiques des patients, le mode de traumatisme et la vélocité de l’impact, exprimée la vélocité deux catégories : « haute » ou « faible ». Les fractures de haute vélocité étaient causées par des chutes de plus d’un étage ou un accident d’automobile. Les fractures de faible vélocité découlaient d’une agression à l’arme contondante ou au poing fermé ou de chutes à partir de la position debout. La position verticale de chaque fracture était mesurée à son point d’entrée sur la structure latérale et à son point de sortie dans l’orifice piriforme. Aux fins de comparaison, les valeurs étaient exprimées selon le ratio de l’endroit sur le visage par rapport à ces points de repère. Le test de Wilcoxon a été privilégié pour comparer la hauteur des fractures causées par des traumatismes à haute et à faible vélocité.</p>
</sec>
<sec><title>RÉSULTATS :</title>
<p>Les résultats ont démontré que les traumatismes faciaux à haute vélocité créaient des fractures de Le Fort I situées à un point plus élevé de la structure latérale que les traumatismes à faible vélocité. Il n’y avait pas de différences de hauteur à l’orifice piriforme.</p>
</sec>
<sec><title>CONCLUSION :</title>
<p>Les traumatismes à haute vélocité entraînaient des profils de fractures de Le Fort I situées à un point plus élevé que les traumatismes à faible vélocité.</p>
</sec>
</trans-abstract>
<kwd-group><kwd>Craniofacial</kwd>
<kwd>Fracture</kwd>
<kwd>LeFort</kwd>
<kwd>Trauma</kwd>
<kwd>Velocity</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
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