Le Fort I and nasal fracture, primary reduction, and secondary revision saddle nose: A case report

Al Hafiz, Wahyu Julianda
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Abstract

Maxillofacial trauma is a common clinical situation in emergency rooms. Lesions involving the maxillofacial complex pose a significant public health challenge, not only due to their costs but also because of the potential functional and aesthetic issues that patients may experience. While some fractures are more suitable for delayed treatment, others necessitate immediate attention, requiring intervention within 24 hours of the trauma occurrence. Different types of reduction and fixation exist depending on the patient’s age, location, type of fracture, and the surgeon’s preferences. We reported a case of a 20-year-old female patient diagnosed with Le Fort I bilateral fracture and closed nasal fracture followed by saddle nose. The patient was managed with open reduction internal fixation and closed reduction nasal bone. The saddle nose in the patient was managed four months later by augmentation rhinoplasty with rib cartilage and pearl fat graft. Proper management of Le Fort I fracture and nasal fracture accompanied with saddle nose by open reduction internal fixation and augmentation rhinoplasty with rib cartilage and pearl fat graft can restore occlusion and improve symmetrical, proportional facial aesthetics, which is the indicators of a successful holistic maxillofacial trauma management.
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Le Fort I 和鼻骨骨折、初次复位和二次修整鞍鼻:病例报告
颌面部创伤是急诊室常见的临床症状。涉及颌面部复合体的病变对公共卫生构成了重大挑战,这不仅是因为其费用高昂,还因为患者可能会出现功能和美观方面的问题。有些骨折更适合延迟治疗,而有些骨折则需要立即治疗,需要在创伤发生后 24 小时内进行干预。根据患者的年龄、骨折部位、骨折类型和外科医生的偏好,有不同的复位和固定方式。我们报告了一例 20 岁女性患者的病例,她被诊断为 Le Fort I 双侧骨折和鼻骨闭合性骨折,随后出现鞍鼻。患者接受了开放复位内固定术和鼻骨闭合复位术。四个月后,该患者通过肋软骨和珍珠脂肪移植隆鼻术治疗了鞍鼻。通过开放复位内固定术和肋软骨及珍珠脂肪移植隆鼻术,妥善处理 Le Fort I 型骨折和鼻骨骨折伴鞍鼻,可以恢复咬合,改善对称、比例协调的面部美观,这是颌面创伤整体治疗成功的标志。
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