Maxillary Fracture: a case of Le Fort II Fracture in a Football Player

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BMJ Case Reports

A case of maxillary fracture in a sportsman

A 19-year-old football player presented to the Emergency Room with a maxillary fracture and loss of consciousness within a few minutes of a collision with a fellow football player while trying to head the ball.

Maxillary fractures: Examination

The doctors examined the patient and found tenderness around the nose and the orbit ( the part of the facial skeleton that holds the eyeball). His pulse, blood pressure and respiratory rate were normal. Moreover, his airway was also patent. His face was heavily bruised near the maxillary fracture and there was a clot present in his nose. However, his mandible was not fractured and non-tender. His eyesight and eye movements were normal. There were no other findings.

Maxillary fractures: Investigations

The doctors performed an X-ray, which only showed a fracture of the nasal bone. Additionally, they performed a facial CT scan, which confirmed the diagnosis of the Le Fort fracture II of the maxilla. The doctors observed a haemorrhage in the brain parenchyma on the Cranial CT scan. They also performed a cervical spine CT which showed no significant findings.

Treatment

A multidisciplinary approach was used for the treatment of the young patient. The doctors performed a nasal tamponade on the patient, after consultation from the ENT, neurosurgery and plastic surgery departments. Thereafter, the doctors admitted the patient to the plastic surgery ward, where they performed his surgery a week later. The surgery involved reconstructing his facial skeleton and the overlying skin.

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