Are Le fort fracture lines relevant in modern trauma?

Midface fractures comprise 23-97% of all facial fractures. Due to the high-speed road traffic injuries (RTI), the fracture pattern has drastically changed from the classic Le Fort pattern to a combination of these lines with varieties. The purpose of this study is to observe the Le Fort fracture lines seen nowadays.

A retrospective observational study was conducted to evaluate the Le Fort fracture pattern lines. The fracture lines were traced using computed tomography of face to visualise the Le Fort fracture line course as described by Rene Le Fort.

Out of 513 patients, isolated Le Fort fracture lines are seen in 40.28% of cases. Ideal fracture lines are seen in only 9%. Combination of Le Fort I and II lines seen in 23%, Le Fort II and III- 10.4%, Le Fort I and III- 6%. All the Le Fort I, II, and III lines were seen in 20% of cases.

This study demonstrates that ideal Le Fort fracture lines are observed in 9%. Rest all fracture lines are either unilateral, incomplete, or in combination. This illustrates the influence of the direction and velocity of the force, along with the mechanism of injury applied to the face, leading to diverse presentations. Therefore, individualised CT-based analysis and reconstruction tailored to the displaced fractured segments are essential for optimal outcome.