Lefort Fractures

Le Fort fractures are fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. In order to be separated from the skull base, the pterygoid plates of the sphenoid bone need to be involved as these connect the midface to the sphenoid bone dorsally. The Le Fort classification system attempts to distinguish according to the plane of injury.

Classification

The commonly used classification is as follows:

  • Le Fort type I
  • Horizontal maxillary fracture, separating the teeth from the upper face
  • Fracture line passes through the alveolar ridge, lateral nose and inferior wall of the maxillary sinus
  • Le Fort type II
  • Pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex.
  • Fracture arch passes through the posterior alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones.
  • Uppermost fracture line can pass through the nasofrontal junction or the frontal process of the maxilla.
  • Le Fort type III
  • Craniofacial disjunction
  • Transverse fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall, and zygomatic arch / zygomaticofrontal suture
  • Because of the involvement of the zygomatic arch, there is a risk of the temporalis muscle impingement
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