A motorcyclist who was not wearing a helmet is brought to the emergency department after a collision. Examination shows gross elongation of the face with a dished-in appearance, the entire midface moving as a single block on gentle traction on the maxilla, depression of the zygomatic arches, and clear fluid dripping from the nose. CT confirms complete craniofacial disjunction. Which level of Le Fort fracture does this represent?
- A Le Fort I
- B Le Fort II
- C Le Fort III ✓
- D Zygomaticomaxillary complex fracture
Correct answer: C. Le Fort III
Explanation
Le Fort III is the highest midface fracture: the entire facial skeleton is separated from the cranial base through the frontozygomatic and zygomaticotemporal sutures, zygomatic arches, orbital walls, ethmoids and nasofrontal region, producing craniofacial dissociation with a dished face and high incidence of CSF leak. In Le Fort II the zygomatic bones remain attached to the skull base, so arch depression and full facial mobility do not occur; that feature distinguishes it from this presentation.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.