Fractures of the Middle Third Le Fort I, II and III |
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The Mid-facial Skeleton Made up of a considerable number of bones which are rarely, if ever, fractured in isolation The structure is such that it is able to withstand considerable force from below, but the bones are easily fractured by relatively trivial forces applied from other directions Analogous to a ‘matchbox’ sitting below and in front of a hard shell containing the brain and differs quite markedly from the rigid projection of the mandible below
Le Fort I Fractures Low-level / Guerin type fractures Horizontal fracture of the maxilla immediately above the teeth and palate Piriform fossa across maxilla to pterygoid fissure May occur as a single entity or in association with le fort II and III fractures Not infrequently present in association with a downwardly displaced fracture of the zygomatic complex
Le Fort II Fractures Pyramidal or suprazygomatic fractures Fracture extends from dorsum of nose, across medial walls of orbit across the maxilla below the zygomatic bone to the pterygomaxillary fissure
Le Fort III Fractures High level or suprazygomatic fractures The facial bones, including the zygomas are detached from the anterior cranial base Fracture line extends from the dorsum of the nose and cribiform plate along the medial and up the lateral wall of the orbit to the ZF suture
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