A Le Fort I fracture involves the maxilla below the nasal floor, canine eminence, lateral antral wall, pterygomaxillary fissure, and pterygoid plate. It is typically treated using closed reduction with mandibulomaxillary fixation or open reduction with plate fixation. A Le Fort II fracture extends above the nasal bone and involves the orbit. It requires surgical management like closed reduction with suspension or open reduction with multiple fixation points. A Le Fort III fracture extends through the frontal bone and involves the orbital roof. It presents with symptoms like edema and requires open reduction and internal fixation at multiple sites.

2. Le Fort I Fracture:

3. Fracture
outline
Pterygoid plate
 Anterior nasal aperture
 Above nasal floor
 Above canine eminence
 Lateral antral wall
 Below zygomatic buttress
 Pterygomaxillary fissure
 Pterygoid plate of bone

4. Clinical features
Diagnosis

5. Imaging:
Coronal cut CT
Three D CT.
Diagnosis

6. Treatment
Closed treatment:
Mandibulomaxillary fixation (MMF)
Either using arch bars or alveolar screws
Better using elastic traction
Suspension wires required to fix fractured
maxilla to the nearest unbroken structure

7. Different sites for suspension

8. Open surgical treatment

9. Open surgical treatment
Two to four
plates used for
maxilla
fixation
The most
common sites
of fixation
Malar bone
and Arround
Anterior nasal
aperture

10. Le Fort II Fracture:
 Above nasal bone
(glabella).
 Lacrimal ethmoid bony
orbit.
 Infra-orbital rim.
 Above canine eminence.
 Lateral antral wall.
 Below zygomatic
buttress.
 Pterygomaxillary fissure.
 Pterygoid plate of bone
Fracture
outline
Le fort II pyramidal fracture

11. Clinical features
Diagnosis

12. Surgical management
Disimpaction

13. Surgical management
Closed
reduction &
suspension
Less effective if
there is delay in
treatment
or
unstable
reduction

14. Surgical management
Open reduction
Multiple
points of
fixation
ensure
better
results

15. Le Fort III Fracture:

16.  Above nasal bone (glabella).
 Frontal ethmoid and sphenoid
bony orbit.
 Zygomatico frontal suture.
 Zygomatico temporal suture.
 Pterygomaxillary fissure.
 Pterygoid plate of bone
Fracture
outline

17. Clinical features:
Edema
Paraesthesia
Circum-orbital ecchymosis
Subconjunctival hemorrhage
Depressed nose.
Epistaxis
CSF
Malocclusion.
Step deformity at zygomatico-frontal
suture

18. Open reduction &
internal fixation
Multiple points of
fixation ensure
better results