Original Research

Defining current facial fracture patterns in a quaternary institution following high-velocity blunt trauma

Senzwesihle C. Magagula, Timothy Hardcastle
South African Journal of Radiology | Vol 20, No 1 | a1005 | DOI: https://doi.org/10.4102/sajr.v20i1.1005 | © 2016 Senzwesihle C. Magagula, Timothy Hardcastle | This work is licensed under CC Attribution 4.0
Submitted: 22 March 2016 | Published: 22 September 2016

About the author(s)

Senzwesihle C. Magagula, Department of Diagnostic Radiology, University of KwaZulu-Natal, South Africa
Timothy Hardcastle, Trauma Service and Trauma ICU, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; Department of Surgical Sciences, University of KwaZulu-Natal, South Africa

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Background: In the early 20th century, René Le Fort studied facial fractures resulting from blunt trauma and devised a classification system still in common use today. This classification, however, was based on low-velocity trauma. In modern practice, in a quaternary-level referral hospital, patients are often admitted following high-velocity injuries that mostly result from motor vehicle collisions.

Objectives: A retrospective study to define facial bone fractures occurring subsequent to highvelocity trauma.

Method: A retrospective study comprising the review of CT scans of 52 patients with highvelocity facial fractures was performed between April 2007 and March 2013. Injuries were classified using the Le Fort classification system. Deviations from the true Le Fort types, which are often depicted in the literature as occurring bilaterally and symmetrically, were documented; these included unilaterality, occurrence of several Le Fort fractures on one side of the face, occurrence of several Le Fort fractures on different levels and on different sides of the face, and occurrence of other fractures in addition to Le Fort fractures.

Results: Of the 52 cases, 12 (23%) had Le Fort injuries, with true Le Fort fractures occurring in only 1, and 11 deviating from the classic description. Nine patients had Le Fort fractures and additional fractures. Mandibular and zygomatic bone fractures were found to be common associations with Le Fort injuries, occurring in 58% and 33% of the cases respectively.

Conclusion: Fractures occurring in modern practice often deviate from the traditional Le Fort classification. Precise recognition of these deviations and recognition of additional associated fractures is pivotal in their management, assisting the surgeon in determining the treatment plan, such as the surgical approach and the order in which to fix the various fractured components.


Maxillofacial facture patterns; High velocity trauma; Le Fort fractures


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