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Le Fort fractures are a classification system of midfacial fractures involving the maxillary bone and surrounding structures, defined by René Le Fort based on experimental trauma models. These fractures result from high-velocity blunt trauma and are categorized into three distinct types based on the pattern of facial separation.

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Anatomical Overview

All Le Fort fractures involve the pterygoid plates, which are mandatory for classification.
The midface is structurally divided into three components:
- Alveolar ridge
- Maxilla and nasal bones
- Orbital and zygomatic structures

Clinical Features

Finding	Implication
Facial swelling and malocclusion	Le Fort I
Infraorbital numbness	Involvement of infraorbital nerve (Le Fort II)
CSF rhinorrhea	Skull base fracture (Le Fort III)
Periorbital ecchymosis, subconjunctival hemorrhage	Orbital involvement (Le Fort II/III)
Facial flattening or mobility on palpation	Suggests Le Fort III
Mobility of maxilla when upper teeth are rocked	Le Fort I or II

Complications

Airway compromise
Malocclusion
Orbital entrapment
Infection/sinusitis
CSF leak, meningitis
Facial deformity

Radiology

https://doi.org/10.1148/rg.2018170074