Here, we’re looking at Le Fort fractures. These are midface fractures. There are three
categories of Le Fort fractures. Collectively, these constitute about 20% of skull fractures
overall. These are due to crash-type injures to the anterior skull. So we see Le Fort I.
Here, we see Le Fort II and then to our far right, we have Le Fort III. If we look at these
individually, we’ll begin with type I. You can see where the red line is and this would represent
the line of fracture in the mid-face. Some considerations here to keep in mind is that this
fracture does lie superior to the maxillary alveolar processes. This would be where the
maxillary teeth are found in the maxilla itself. So we’re looking at structures that would then
span the nasal septum as you come across here, across the mid-face. Then, this type of Le Fort
fracture may also involve the pterygoid plates that are features of the sphenoid bone.
Type II Le Fort fractures occur along the fracture line here shown in red. Structures that are
along this fracture line would include the posterolateral parts of the maxillary sinuses
would lie within this area here. Over on the opposite side, the infraorbital foramina
are in this area of fracturing. Lastly, the lacrimal or ethmoid bones may be fractured along
the fracture line of a type II. The third and final type of Le Fort fracture is simply identified
as type III. This lies most superiorly with respect to the other two types, as we can see
the fracture line coming across here. Horizontal fracture, upper midface, passes through,
kind of hard to detect here but will pass through the superior orbital fissures, involves
the ethmoid and nasal bones, hard to see the ethmoid involvement in this view but you can
see involvement of the nasal bones. It would involve the greater wings of the sphenoid bone.
Then lastly, which we can appreciate, it would involve the frontozygomatic suture.
So that suture lies right in through here on this side and right in through the opposite side.