0:01

To understand the mechanism of injury and also

0:05

the combination of fractures that may occur,

0:08

people have described the vertical and transverse

0:12

buttresses of the mid face. And these

0:15

are demonstrated in this diagram.

0:17

The two transverse buttresses are seen in the coloration here

0:23

as the squamosal temporal bone, which is, this is portion of

0:27

the squamosal temporal bone to the nasofrontal

0:31

junction, across the zygomatic arch.

0:34

So here you can see the zygomatic arch and then

0:37

we're going to the nasofrontal junction.

0:39

Remember, we had our frontonasal suture here and our frontal

0:43

maxillary sutures and frontonasal sutures here,

0:46

and this involves the inferior orbital rim.

0:49

So this is one of the transverse buttresses.

0:52

The second buttress goes from the hard palate across the

0:57

maxilla here, and these are the mid-face buttresses.

1:02

The mandible down here is not actually

1:04

considered portion of the mid-face.

1:08

In addition,

1:09

there are two vertical buttresses and we see these

1:12

here. Unfortunately, both of them are in this orange coloration.

1:16

So the first one is along the posterior maxillary molars,

1:20

it goes to the zygomaticmaxillary suture

1:25

and then it goes along the lateral orbital rim, and

1:29

these are fractures that occur often in concert.

1:33

This may extend to the zygomaticafrontal

1:36

suture which you see right here.

1:39

The second one is the one that is on either side of the midline

1:43

along the nasal cavity, and that goes from the anterior nasal spine

1:48

region across the maxilla to the nasofrontal junction,

1:53

and then from there, into the frontal bone.

1:55

This may affect the medial orbital wall.

1:58

So, fractures of this particular area here on either side of the

2:05

midline, are generally what we refer to as the naso

2:08

orbital ethmoidal fractures, or NOE fractures,

2:12

which is what we are going to describe next.

Case 5 - Midface Butresses

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