Initially described in 1901 by French surgeon René Le Fort (1869-1951), LeFort fractures represent a group of midface fractures that occur following blunt trauma and follow areas of structural weakness. 5.3.2 Closed Method (less preferred in contemporary practice).5.3.1 Open Method (most commonly used today).3.5.3 Le Fort Type III (Transverse, aka Craniofacial Dysfunction). ![]() Analysis of demographic distribution and treatment in 2901patients (25-year experience). Mund Kiefer GesichtsChir 11(4):201–208Įrol B, Tanrikulu R, Görgün B (2004) Maxillofacial fractures. Kühne CA, Krueger C, Homann M, Mohr C, Ruchholtz S (2007) Epidemiologie und Behandlungsmanagement bei Schockraum patienten mit Gesichtsschädelverletzungen. Sports-related maxillofacial fractures: a retrospective study of 125 patients. ![]() Craniomaxillofac Trauma Reconstr 05(01):41–50 Kraft A, Abermann E, Stigler R et al (2012) Craniomaxillofacial trauma: synopsis of 14,654 cases with 35,129 injuries in 15 years. ![]() Ludi EK, Rohatgi S, Zygmont ME, Khosa F, Hanna TN (2016) Do radiologists and surgeons speak the same language? A retrospective review of facial trauma. e Coronal CT image of the same patient shows a fracture of the inferior aspect of the maxillary sinus walls (thin arrows), a type I Le Fort fracture, and a fracture of the inferomedial orbital walls, a Le Fort type II fracture (thick arrows) Patient 2: d Axial CT image at an inferior level of the maxillary sinuses demonstrates bilateral fractures through the pterygoid plates (arrowheads) and maxillary sinus walls (arrows), findings indicative of Le Fort type I fractures. c Coronal image shows involvement of the inferior orbital rim, illustrating the definition of a Le Fort type II fracture (thin arrow). b Axial image at the level of the inferior margin of the orbits shows zygomatic fractures on the right side, illustrating the definition of a Le Fort III fracture (thick arrow). Patient one: a axial CT image at the level of the inferior maxillary sinus shows fractures in both pterygoid plates (arrowheads). a– c Patient one and ( d, e) patient two. Two patients with multiple Le Fort fractures. It is essential to categorize fracture patterns and highlight features that may affect fracture management in radiology reports of facial trauma.įacial trauma Le Fort Mandibular fractures Naso-orbito-ethmoid fractures Zygomaticomaxillary complex fracture. Frontal sinus fractures that extend through the posterior sinus wall can create a communication with the anterior cranial fossa resulting in leakage of cerebrospinal fluid, intracranial bleeding. Orbital fractures can also result in injuries to the globe or infraorbital nerve. In orbital fractures, entrapment of the inferior rectus muscles can lead to diplopia, so it is important to assess its positioning and morphology. Severe comminution or angulation can lead to wide surgical exposure. Displaced fractures of the zygomaticomaxillary complex often widen the angle of the lateral orbital wall, resulting in increased orbital volume and sometimes in enophthalmos. The classification of naso-orbito-ethmoid depends on the extent of injury to the attachment of the medial canthal tendon, with possible complications like nasofrontal duct disruption. Conceptualized when low-speed trauma was predominant, the Le Fort classification system has become less relevant giving more importance on maxillary occlusion-bearing segments. These fractures are classified in three basic patterns that can be combined and associated with various complications. In Le Fort fractures, there is a breach between the pterygoid plates and the posterior maxilla. It has helped clinical management and surgical planning, so radiologists must communicate their findings to surgeons effectively. ![]() In patients with facial trauma, multidetector computed tomography is the first-choice imaging test because it can detect and characterize even small fractures and their associated complications quickly and accurately.
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