Le Fort Fracture Initial Management — NDEB AFK MCQ

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HardMedical Emergencies in DentistryLe Fort Fracture Initial ManagementNDEB AFK

Which of the following is the most appropriate initial management of a midface (Le Fort) fracture with active epistaxis (nosebleed) in the emergency setting?

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Correct answer: C — Stabilise the airway (possible intubation or surgical airway), control haemorrhage with anterior/posterior nasal packing, IV fluid resuscitation, and preparation for surgical reduction

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · A = shown as D · B = shown as E

Midface (Le Fort) fractures are often associated with significant haemorrhage from branches of the maxillary artery and/or anterior ethmoidal artery. Initial management priorities follow ATLS protocol: (A) Airway — secure the airway (may require intubation or surgical airway if severe midface disruption causes airway compromise); (B) Breathing — assess for associated thoracic injuries; (C) Circulation — control haemorrhage (anterior/posterior nasal packing, Foley catheter posterior pack), IV fluid resuscitation, blood transfusion if needed. Definitive fracture reduction is performed after the patient is stabilised.

Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019