Le Fort I, unilateral comminution

A comminuted fracture line extends from the piriform aperture through the lateral maxillary and lateral nasal wall to the posterior region on one side. Collaterally, there is a simple fracture line following a similar course.  A segment of pterygoid plates will often be included.

These fractures can occur without defect (ie, fragments can be fixed to the plate/plates), or with defects in which cases the fragments cannot be used for fracture fixation and buttressing.

This illustration shows a Le Fort I fracture with unilateral comminution (without defect).

In cases of comminution with small fragments, surgical exposure may require these fragments be removed, resulting in a defect fracture.

This illustration shows a Le Fort I fracture with unilateral comminution with defect.

3-D CT scans show a Le Fort I fracture in the same patient.