Le Fort Fractures: A Narrative Review of Diagnosis and Management
DOI:
https://doi.org/10.20956/nmsj.v10i1.48840Abstract
Le Fort fractures represent complex midfacial fractures
typically resulting from high-velocity trauma,
characterized by the separation of the maxillary structure
from the cranial base. This narrative review synthesizes
contemporary literature regarding the etiopathogenesis,
classification, diagnosis, and management of these
fractures. Diagnosis requires a comprehensive clinical
assessment supplemented by non-contrast computed
tomography (CT) as the gold standard for delineating
fracture patterns and buttress involvement. The review
discusses the clinical relevance of classical Le Fort
classifications alongside Wassmund and Marciani
modifications to guide surgical planning. Management
strategies prioritize initial stabilization according to
Advanced Trauma Life Support (ATLS) principles,
particularly airway control, followed by definitive surgical
intervention. Open reduction and internal fixation (ORIF)
remains the primary surgical modality, focusing on the
restoration of vertical and horizontal buttresses,
occlusion, and orbital integrity. Postoperative care is
critical for preventing complications such as infection,
malunion, and ocular dysfunction. Ultimately, successful
management necessitates a multidisciplinary approach
combining precise imaging and rigid fixation to restore
facial aesthetics and function while minimizing long-term
morbidity.
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