, Although traditional helmets have been shown to reduce cranial injuries, they leave the mid and lower face unprotected. The use of protective equipment in sports such as helmets, facemasks, and intraoral mouthguards has significantly reduced the number of craniofacial injuries. Preventing Injuries with Protective Equipment , This chapter reviews pertinent anatomy, initial patient workup, and principles of surgical repair with an emphasis on Le Fort pattern fractures related to sports. Sporting fracture mechanisms typically include player–player collisions and impact from equipment such as a ball–face impact with improper protective equipment. Le Fort level fractures are more common in high-velocity sports such as mountain biking or skiing. Studies noted significant bony injury to the midface with these fractures.įacial fractures due to sporting injuries are generally less severe than those caused by MVAs and are associated with shorter hospitalization time. , In recent years, there has been a rise in craniofacial injuries related to motor scooters with the introduction of electronic scooters to many cities. Sporting injuries account for 10% to 42% of all facial fractures, with midface fractures accounting for a large percentage of these injuries. Motor vehicle accidents (MVAs), interpersonal violence, industrial accidents, falls, and sports-related injuries are common mechanisms of injury.
Le Fort fractures typically occur due to blunt impact to the midface. The location of the injury, velocity and energy transfer at impact, and patient-related factors determine the fracture severity and pattern. Le Fort level fractures are complex facial fractures that are differentiated as I, II, and III based on fracture patterns. The sequence of fracture repair is variable. The patient is placed in maxillomandibular fixation (MMF) to facilitate reduction and establish the original occlusive relationship. Surgery is indicated for most displaced Le Fort fractures to restore function and facial harmony. Le Fort fractures can contribute to airway obstruction and urgent intubation may be indicated. Sporting injuries are a common cause of facial trauma however, use of protective equipment has reduced the number of sports-related craniofacial injuries. Le Fort fractures occur at uniform weak areas in the midface often due to a blunt impact to the face.
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