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Related Concept Videos

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Related Experiment Video

Updated: Jul 25, 2025

Three-Dimensional Reconstruction of Orbital Fractures
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Facial fractures: The "bottom-up" approach.

Sergey Kochkine1, Alexander B Baxter2, John M McMenamy3

  • 1Division of Emergency Radiology, Department of Radiology, Stony Brook University Renaissance School of Medicine, Stony Brook University Hospital, 101 Nicolls Road, Stony Brook, NY 11794, USA.

Clinical Imaging
|June 28, 2023
PubMed
Summary

A bottom-up approach to facial CT scans aids trauma radiologists in quickly classifying complex facial fractures. Evaluating the mandible, pterygoid plates, zygoma, and orbits sequentially improves efficiency and accuracy in trauma centers.

Keywords:
Facial fracturesLe Fort fractureMandibular fracturesNasal bone fractureNaso-orbital-ethmoid fractureZygomaticomaxillary complex fracture

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Area of Science:

  • Radiology
  • Medical Imaging
  • Trauma Surgery

Background:

  • Trauma radiologists face high-volume image evaluation demands in busy centers.
  • Accurate and efficient facial fracture classification is crucial for patient management.

Purpose of the Study:

  • To propose a practical, bottom-up approach for rapid facial fracture complex characterization.
  • To enhance diagnostic efficiency and communication in trauma settings.

Main Methods:

  • Sequential evaluation of four key facial landmarks: mandible, pterygoid plates, zygoma, and bony orbits.
  • Utilizing a process of exclusion and elimination from bottom to top.
  • Integrating fracture classification with recognition of associated soft tissue injuries.

Main Results:

  • A bottom-up approach facilitates rapid characterization of facial fractures.
  • Clearing specific landmarks rules out common fracture types (panfacial, Le Fort, ZMC, NOE).
  • This method simplifies complex fracture assessment in high-volume trauma cases.

Conclusions:

  • A systematic bottom-up CT evaluation strategy improves efficiency for trauma radiologists.
  • This approach aids in accurate fracture classification and communication for timely treatment decisions.
  • Recognizing associated soft tissue injuries remains critical in facial trauma reporting.