PALATAL FRACTURES - CLASSIFICATION, PATTERNS, AND TREATMENT WITH RIGID INTERNAL-FIXATION

A classification of palatal fracture types is developed from patterns observed on CT scans, and success with open reduction techniques is co rrelated with fracture pattern. The six palatal fracture types are as follows: I, anterior and posterolateral alveolar; II sagittal; III, pa rasagittal; IV, para-alveolar; V, complex; and VI, transverse. Associa ted fractures were LeFort I (100 percent), LeFort II and III (55 perce nt), mandible (48 percent), and dental (55 percent). Large segment, sa gittally oriented palatal fractures could be stabilized with rigid int ernal fixation. Complete rigid fixation of the palate consists of (1) roof of mouth, (2) pyriform or alveolar, and (3) four LeFort I buttres s stabilization. Comminuted palatal fractures were managed by standard LeFort I and alveolar buttress fixation, palatal splinting, and inter maxillary fixation. If complete rigid fixation was employed in the pal ate in type II, III, and IV fractures, a palatal splint was avoided in 60 percent of these cases. Rigid internal fixation is therefore concl uded to facilitate the treatment of certain types of palatal fractures by reduced length of intermaxillary fixation and avoidance of palatal splinting.