Le Fort 1 fractures

Case contributed by Dr Heather Pascoe

Presentation

Trauma.

Patient Data

Age: 90 years
Gender: Male
CT

Bilateral Le Fort I facial fractures, with bilateral pterygoid plate fractures and comminuted fractures through the maxillary sinuses. No orbital wall or zygomatic arch fractures.

Bilateral nasal bone fractures.

The fracture through the right maxilla passes through the right nasolacrimal duct. No mandibular fractures are evident.

The temporomandibular joints are normally enlocated.

Extensive left pre-septal orbital soft tissue swelling, without post-septal orbital injury evident.

No intraorbital hematoma.

Hematoma within the maxillary sinuses, and extensive traumatic stranding in the associated soft tissues noted.

Incidentally, extensive calcification around the dens likely relates to hydroxyapatite deposition.

Case Discussion

Le Fort 1 fractures are essentially a horizontal maxillary fracture, separating the teeth from the upper face.

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