CONTEMPORARY APPROACHES IN THE DIAGNOSIS OF LE FORT FRACTURES: A LITERATURE REVIEW

Abstract

Le Fort–type fractures represent one of the most complex and challenging conditions in facial trauma due to their high clinical severity, potential functional and aesthetic impairment, and the diagnostic difficulty resulting from the anatomical complexity of the midface. Most cases are associated with high-energy trauma, such as assaults and motor vehicle accidents, predominantly affecting young men. Clinical diagnosis should be based on a thorough physical examination, including inspection, palpation, and assessment of bone mobility, as well as the identification of signs such as malocclusion, crepitus, edema, and bilateral epistaxis. However, diagnostic confirmation depends on high-precision imaging exams, such as Cone-Beam Computed Tomography (CBCT), considered the gold standard because it enables detailed three-dimensional reconstructions and precise visualization of fracture lines, overcoming limitations of conventional radiography. Waters, Caldwell, Towne, and Hirtz radiographic views may still be useful in specific cases, while complementary methods such as magnetic resonance imaging and ultrasonography assist in evaluating soft tissues and diagnosing associated injuries. Thus, it is concluded that effective diagnosis of Le Fort fractures must be grounded in a multidisciplinary approach that integrates careful clinical assessment with advanced imaging methods, ensuring greater accuracy in identifying the extent of lesions and enabling adequate surgical planning for functional and aesthetic restoration of the traumatized patient, ultimately improving their quality of life.

DOI: https://doi.org/10.56238/sevened2025.036-060