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Fig. 7D. —Combined Le Fort I fracture on right and Le Fort II and III
fractures on left. Look at four facial segments one side at a time. First,
look at the right side: pterygoid process (fractured in this case: Le Fort
fracture is most likely present), right anterolateral margin of nasal fossa
above maxillary alveolar ridge (fractured: Le Fort I is likely present),
inferior orbital rim on right (intact: Le Fort II is excluded), and zygomatic
arch on right (intact: Le Fort III is excluded). Right-sided Le Fort I
fracture is confirmed by noting other expected fractures in plane of Le Fort I
fracture. Next, look at the left side: pterygoid process (fractured in this
case: Le Fort fracture is most likely present), left anterolateral margin of
nasal fossa above maxillary alveolar ridge (intact: Le Fort I is excluded),
left inferior orbital rim (fractured: Le Fort II is likely present), and left
zygomatic arch (fractured: Le Fort III is likely present). Left-sided Le Fort
II and III fractures are confirmed by noting other expected fractures in
planes of Le Fort II and III fractures. Coronal CT image shows fracture of
lateral orbital rim (frontal process of zygoma) on left (solid
arrow); Le Fort III fracture is present on left, because lateral rim is
also a unique feature of Le Fort III fractures. Left orbital floor on left
(open arrow) is fractured, as is expected in Le Fort II fractures.
Right orbital floor is intact.
