Le Fort III Fracture — ORE Part 1 MCQ

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HardOral SurgeryLe Fort III FractureORE Part 1

Following facial trauma, a patient has marked posterior displacement of the midface ('dish-face' deformity). There is bilateral subconjunctival haemorrhage with no visible posterior limit. Which fracture pattern is most likely?

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Correct answer: D — Le Fort III fracture

D. Le Fort III fracture is correct. This fracture produces craniofacial disjunction, so the entire midface can move posteriorly, causing the characteristic flattened or retruded 'dish-face' appearance. Bilateral subconjunctival haemorrhage with no visible posterior limit is a classic sign in Le Fort injuries and supports a high midfacial fracture. Le Fort I is confined to the lower maxilla and does not explain orbital signs or marked global midface retrusion. Le Fort II involves the central midface and orbital rims but is less likely to cause the complete craniofacial separation responsible for a dish-face deformity. Zygomatic complex fractures usually cause unilateral malar and orbital signs, while isolated nasal fractures do not cause this constellation.

Reference: Phillips BJ, Turco LM. Le Fort Fractures: A Collective Review. Bulletin of Emergency and Trauma. 2017. https://pubmed.ncbi.nlm.nih.gov/29177168/