Le Fort fractures: a review

Authors

  • Erick Fernando Hernández Department of General Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
  • Sofia Barrientos Villegas Departament of SCIRCES, UCES, Medellin, Colombia
  • Daniel E. Aguilera-Callejas Department of General Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
  • José Manuel Gómez González Department of General Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
  • Ana Paula Cortés-Contreras Department of General Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
  • Jorge Gómez-González Department of Physiology, Faculty of Medicine, UNAM, Namibia
  • Baltazar Barrera Mera Department of Physiology, Faculty of Medicine, UNAM, Namibia
  • Fernando Rosas López Portillo Department of Clinical Research, UAS, Sinaloa, Mexico
  • Cinthia Nayeli Arguelles Castillo Department of Diagnostic and Therapeutic Imaging, Dr. Manuel Gea Gonzalez Hospital, CDMX, Mexico
  • Alan Isaac Valderrama-Treviño Department of Angiology, Vascular and Endovascular Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20241301

Keywords:

Le Fort fractures, Facial fracture, Facial trauma, Le Fort, Mandibular fracture, Trauma

Abstract

Rene Le Fort proposed 3 classifications to determine the type of facial fracture based on the main facial lines with the least resistance, these being the places where facial fractures are most located. These fractures occur mainly because of high-velocity impact mechanisms. Le Fort fractures are difficult to manage and at the same time challenging, although it is not a common pathology, it is potentially lethal, and its initial approach and resuscitation are critical in the first hours. As in any other trauma, an initial evaluation must be carried out exhaustively and following the ABC, which mainly includes evaluation of the airway, breathing and circulation. Once a facial fracture is suspected, its extension and location must be determined through images such as x-ray or computed tomography. CT being the gold standard. Once the patient is stabilized, reconstructive surgery will be the indicated approach in most cases, with the main objective being the restoration of occlusion, direct exposure and manual reduction of the fractures, reconstruction of the medial and lateral bone buttresses, restoring the projection of the face and restore the width of the maxillary arch, nose and orbit. In general, some of the most frequently described postoperative complications are hemorrhage, infection, foreign body reaction, malunion, among others; however, these will vary depending on their classification.

 

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Published

2024-05-14

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Section

Review Articles