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Le Fort fractures

Rhea & Novelline 2005CTTrauma
Figures · click to enlarge
Le Fort I, II and III planes on one skull
Le Fort I: horizontal maxillary fracture
Le Fort II: pyramidal fracture
Le Fort III: craniofacial disjunction

All three types disrupt the pterygoid plates. Each has one fracture unique to it, which makes CT identification fast. Types frequently coexist and may differ side to side.

TypePatternUnique componentMobile segment
IHorizontal through maxilla above the alveolar ridgeAnterolateral margin of the nasal fossa (piriform aperture)Palate + alveolar process ("floating palate")
IIPyramidal: nasofrontal junction, medial orbit, inferior orbital rim, zygomaticomaxillary regionInferior orbital rimMaxilla + nose ("floating maxilla")
IIITransverse craniofacial disjunction: nasofrontal junction, medial and lateral orbital walls, zygomatic archZygomatic archEntire midface ("floating face")

Reading algorithm

  • Step 1: Are the pterygoid plates fractured? If not, it is not a Le Fort fracture.
  • Step 2: Check anterolateral nasal fossa margin (I), inferior orbital rim (II), zygomatic arch (III).
  • Step 3: Confirm the remaining expected components. Report each side separately.

Sources

  1. Rhea JT, Novelline RA. How to simplify the CT diagnosis of Le Fort fractures. AJR Am J Roentgenol. 2005;184:1700–1705.PubMed ↗
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Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.