Le Fort fractures all have involvement of the pterygoid plates. Le Fort patterns are divided into Le Fort I, Le Fort II and Le Fort III.
With Le Fort I Fractures you expect to see fractures of the pterygoid plates, the anterior, posterolateral and medial maxillary sinus walls resulting in disarticulation of the maxilla from the rest of the face.
With Le Fort II Fractures, there are fractures of the pterygoid plates, the nasal bone, the medial orbital wall, orbital floor, anterior wall of the maxillary sinus and posterolateral wall of the maxillary sinus. The orbital floor is the anatomic structure that is unique to Le Fort II and not involved in Le Fort I or Le Fort III. The shape of the fracture pattern is pyramidal.
Le Fort III fracture pattern includes the pterygoid plates, the nasal bone, the medial and lateral orbital walls and zygomatic arch. The lateral orbital walls and zygomatic arch is unique to Le Fort III and not seen in Le Fort I or Le Fort II.
Many patients will have a combination of fractures Le Fort I, Le Fort II and Le Fort III and may be asymmetric from side to side.
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