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Facial fracture - Le Fort type III

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Facial trauma

Patient Data

Age: 45 years
Gender: Male
  • transverse fracture line through both frontal sinuses, orbital walls and left frontozygomatic suture
  • fracture alveolar process of maxilla (hard palate)
  • fractured pterygoid bones
  • fractured bones of both maxillary and frontal sinuses as well as ethmoid air cells with retained fluid (hemosinus)
  • fracture orbital walls with bilateral orbital emphysema.
  • prefrontal subcutaneous emphysema and hematoma
  • bilateral nasal bone fractures
  • mandibular symphyseal fracture with bilateral temporomandibular joints dislocation

Case Discussion

Le Fort fractures are easily detected by the presence of pterygoid plate fractures, which if exist, you have to proceed to know which type of Le Fort fracture:

  • type I - a fracture line passes through the alveolar ridge
  • type II - a pyramidal fracture passes from the nasofrontal junction, nasal bones, inferior orbital rim, lateral maxillary walls, and posterior alveolar ridge
  • type III - a transverse fracture passes through the nasofrontal suture, maxillofrontal suture, orbital walls, zygomatic arch/zygomaticofrontal suture

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