Some thoughts on the classification and treatment of Le Fort fractures.

A system is proposed which defines the Le Fort fracture pattern more precisely and allows one to compare fractures and describe them adequately. The system involves a description of the highest level of Le Fort fracture on each side, a description of the fragment that carries the maxillary dentition, and a description of accompanying nasoethmoidal or mandibular fractures. The areas that must be considered for open reduction are thus precisely defined and represent the weak structural areas of the maxilla as defined by Le Fort in his experiments. Open reduction should progress from stable bone to stable bone, replacing with bone grafts those areas that are unsatisfactory for interfragment wiring. Aesthetic results obtained are superior and more predictable than after treatment with classical Adam's fixation.