2020–2021 BCSC Basic and Clinical Science Course™
7 Oculofacial Plastic and Orbital Surgery
Part I: Orbit
Chapter 6: Orbital Trauma
Midfacial (Le Fort) Fractures
Le Fort fractures involve the maxilla and are often complex and asymmetric (Figs 6-1, 6-2). By definition, Le Fort fractures extend posteriorly through the pterygoid plates. These fractures may be divided into 3 categories, although clinically they often do not conform precisely to these groupings:
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Le Fort I fractures are low transverse maxillary fractures above the teeth with no orbital involvement.
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Le Fort II fractures generally have a pyramidal configuration and involve the nasal, lacrimal, and maxillary bones as well as the medial orbital floor.
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Le Fort III fractures cause craniofacial disjunction, in which the entire facial skeleton is completely detached from the base of the skull and is suspended only by soft tissues. The orbital floor as well as the medial and lateral orbital walls are involved.
Treatment may include dental stabilization with arch bars and open reduction of the fracture with rigid fixation using titanium plating systems.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.