First, look at the right side: pterygoid process (fractured in this case: Le Fort fracture is most likely present), right anterolateral margin of nasal fossa above maxillary alveolar ridge (fractured: Le Fort I is likely present), inferior orbital rim on right (intact: Le Fort II is excluded), and zygomatic arch on right (intact: Le Fort III is excluded). Look at four facial segments one side at a time. Combined Le Fort I fracture on right and Le Fort II and III fractures on left. If the zygomatic arch is intact, a Le Fort III fracture is excluded.įig. If the pterygoid processes are broken and the zygomatic arch is broken, probably a Le Fort III fracture is present. The zygomatic arch is easily seen on axial or 3D CT images of the face (Fig. The Le Fort III fracture is the only one that involves the zygomatic arch. Sagittal CT image shows fracture across nasal bone ( arrow) that might be seen in either Le Fort II or III fracture.
Le Fort II fracture is confirmed by noting other expected fractures in plane of Le Fort II fracture. To classify this Le Fort fracture, look at the following four facial segments: pterygoid processes (fractured in this case: Le Fort fracture is most likely present), anterolateral margins of nasal fossa above maxillary alveolar ridge (intact: Le Fort I is excluded), inferior orbital rims (fractured: Le Fort II is likely present), and zygomatic arches (intact: Le Fort III is excluded). If the inferior orbital rim is intact, a Le Fort II fracture is excluded.įig. If the pterygoid processes are broken and the inferior orbital rim is broken, probably a Le Fort II fracture is present. The inferior orbital rim is also easily seen on coronal or 3D CT images of the face (Fig. The Le Fort II fracture is the only one that involves the inferior orbital rim. Horizontally oriented fractures across maxillary sinuses and nasal fossa ( white arrows) are seen. Three-dimensional image in frontal projection shows intact inferior orbital rims ( black arrows), thus excluding Le Fort II fracture. Le Fort I fracture is confirmed by noting other expected fractures in plane of Le Fort I fracture. To classify this Le Fort fracture, look at the following four facial segments: pterygoid processes (fractured in this case: Le Fort fracture is most likely present), anterolateral margins of nasal fossa above maxillary alveolar ridge (fractured: Le Fort I is likely present), inferior orbital rims (intact: Le Fort II is excluded), and zygomatic arches (intact: Le Fort III is excluded). The purpose of this pictorial essay is to illustrate the use of these unique components to easily and quickly identify which type of Le Fort fracture is present.įig. In addition, each of the Le Fort fractures has a unique component. It is rare for the pterygoid processes to be fractured in the absence of a Le Fort fracture. Although visualization of injury to the struts and buttresses of the face is required for repair of these fractures with restoration of the 3D stability and symmetry of the face, the Le Fort classification appears to be a succinct way of summarizing and communicating the major planes of certain fractures.Ĭommon to all Le Fort fractures is fracture of the pterygoid processes. Le Fort and maxillary fractures accounted for 25.5% of 663 facial fractures recently reported from a level 1 trauma center. The classification of these fractures includes Le Fort I, II, and III types of fractures. Rene Le Fort described the planes of injury that result from significant force to the midface.
0 kommentar(er)
