FIG. 7.27 Le Fort midfacial fractures. A, Le Fort I fracture separating inferior portion of maxilla in horizontal fashion, extending from piriform aperture of nose to pterygoid maxillary suture area. B, Le Fort II fracture involving separation of maxilla and nasal complex from cranial base, zygomatic orbital rim area, and pterygoid maxillary suture area. C, Le Fort III fracture (i.e., craniofacial separation), which is a complete separation of midface at level of naso-orbital-ethmoid complex and zygomaticofrontal suture area. The fracture also extends through orbits bilaterally. (From Hupp JR, Ellis E III, Tucker MR: Contemporary oral and maxillofacial surgery, ed 6, St Louis, 2014, Mosby.)
• Diagnosis of facial fractures is made with the use of x-ray and CT scan.
• For repair of any facial fracture, Triclosan (broad-spectrum antimicrobial agent) and PCMX (parachlorometaxylenol) are used as prep, but these solutions should not be allowed to enter the patient’s eyes. Warm sterile water is used for rinsing.
• Hexachlorophene and chlorhexidine are not used on the face because they are ototoxic. A sterile cotton ball should be placed in the ear during prep of the surgical site.
Maxillomandibular Fixation (MMF)
• This the name given to the application of arch bars (Fig. 7.28).
• If this procedure performed for Le Fort I, II, or III, the surgical technologist in the scrub role must have two setups ready.
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