The Le Fort type III fractures begin at the nasofrontal and frontomaxillary sutures and extend along the medial wall of the orbit through the nasolacrimal groove and ethmoid air cells.
These fractures involve the pterygoid plate (as in all Le Fort fractures) and the zygomatic arch or cheek bone. The Le Fort type III fracture (transverse) is also known as the craniofacial dissociation and is caused by impact to the nasal bridge or upper maxilla. Symptoms: step deformity at infraorbital margin, mobile mid face, anesthesia or paresthesia of cheek. In this type, the hard palate and nose move but eyes do not. The Le Fort type II fractures might be stable or unstable pyramidal fractures that occur through central maxilla and hard palate. The lacrimal bones (which contains the tear ducts) and inferior orbital floor (through or near the infraorbital foramen) are part of the infolateral dimension of this fracture. The Le Fort type II fractures extend from the nasal bridge at or below the nasofrontal suture through the superior medial wall of the maxilla. The fracture got its classification name as pyramidal due to the characteristic pyramid shape of the fracture when viewed from the front. In addition to the pterygoid plate, the inferior orbital rim is involved. Le Fort type II fracture (pyramidal) may occur due to a blow to the lower or mid maxilla. The presence of the ecchymosis of the greater palatine vessels characterises the Guerin’s sign. The Le FortI fracture is diagnosed only by grasping the maxillary teeth and applying a little firm pressure to feel the characteristic grate.
The buccal sulcus beneath each zygomatic arch is has the ecchymosis is also affected. Symptoms: The symptoms of this include slight swelling of the upper lip, mobility of teeth. Only the hard palate and teeth move in this type. The Le Fort type I fractures are stable transverse fractures separating body of maxilla from pterygoid plate and nasal septum. This type of fracture is also called Guerin fracture. The medial and lateral buttresses (walls) of the maxillary sinus, the parts of the face just above the alveolar ridge of the upper dental row are involved. The pterygoid plate and lateral bony margin of the nasal opening are involved in the Le Fort type I fracture. Le Fort I fractures also known as the floating palate might be the result of a force of injury directed on the lower part of the maxillary alveolar rim or upper dental row, downwards. While the Le Fort type I fracture is isolated to the lower face, the Le Fort type I and Le Fort type II fractures are associated with cribriform plate disruption and CSF rhinorrhea. There are 3 major types of Le Fort fractures based on the affected area. Motor vehicle accidents are the main cause of the Le Fort fractures. They account to around 10-20% of all facial fractures. The pterygoid plates (they connect the midface to sphenoid bone dorsally) are involved in the Le Fort fractures. The Le Fort fractures are the types that involve separation of all or part of the midface from the skull base. The surgery procedures for Le Fort fractures of trauma victims requires fixation to a horizontal bar of the frontal bone. The stability of the midface region depends on the continuity of this structure. Le Fort fractures are identified by the characteristic pterygomaxillary separation – the fraction between the pterygoind plates, the horseshoe shaped bony protruberances that originate at the inferior margin of the maxilla and maxillary sinuses. This includes the maxillary bone and surrounding structures in the horizontal, pyramidal or transverse direction. He discovered the unique fracture patterns by examining crush injuries in cadavers.Ī Le Fort fracture of the skull is a panfacial fracture that occurs in the mid facial region. The Le Fort fractures are named after the French surgeon Rene Le Fort.
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