What kind of surgeon treats a Le Fort fracture?

From the Guidelines

A maxillofacial surgeon or oral and maxillofacial surgeon is the most appropriate specialist to treat a Le Fort fracture, given their unique training in both dentistry and medicine to handle complex facial fractures. Le Fort fractures are serious injuries that involve fractures of the midface, categorized into three types (Le Fort I, II, and III) based on the fracture pattern and severity, as described in the study by Parsons et al 1. These fractures often require a multidisciplinary approach, potentially involving neurosurgeons, ophthalmologists, and other specialists depending on associated injuries, such as cranial nerve deficits or infraorbital nerve (V2) deficits, which can be assessed using MRI as a supplement to CT scans 1.

Key Considerations

• Le Fort fractures involve the pterygoid plates and can result in a mobile hard palate relative to the remainder of the midface, as seen in Le Fort I injuries, or a mobile hard palate and nose in relation to the balance of the face, as seen in Le Fort II injuries 1.
• Treatment usually involves surgical reduction and fixation using titanium plates and screws to stabilize the fractured bones, with the goal of restoring proper function and appearance.
• Prompt surgical intervention is crucial to prevent complications such as facial deformity, malocclusion (improper bite), and vision problems, highlighting the importance of timely referral to a maxillofacial surgeon or oral and maxillofacial surgeon.

Important Factors

• The severity and pattern of the fracture, as well as associated injuries, will guide the treatment approach and the need for a multidisciplinary team.
• The use of MRI as a supplement to CT scans can be useful in characterizing cranial nerve deficits or infraorbital nerve (V2) deficits, as noted in the study by Parsons et al 1.
• Recovery typically takes 6-8 weeks for initial healing, though complete recovery may take several months, emphasizing the need for ongoing care and follow-up with a maxillofacial surgeon or oral and maxillofacial surgeon.

From the Research

Surgeon Specialization for Le Fort Fractures

The type of surgeon that treats a Le Fort fracture is typically a:

• Maxillofacial surgeon, who specializes in surgical procedures of the face, jaw, and mouth 2, 3, 4, 5, 6
• Oral and maxillofacial surgeon, who is trained to treat injuries and defects of the face, jaw, and mouth 2, 3, 5
• Plastic surgeon, who may also be involved in the treatment of Le Fort fractures, particularly in cases where there are significant soft tissue injuries or cosmetic concerns 2, 4

Surgical Approaches

The surgical approach for treating Le Fort fractures may involve:

• Open reduction and internal fixation, which is a common method used to treat these fractures 3, 6
• Le Fort I osteotomy, which is a surgical procedure that involves cutting and repositioning the maxilla to restore proper alignment and occlusion 2, 5
• Endoscopic-assisted minimally invasive methods, which may be used in combination with other approaches to treat complex midfacial fractures 5

Treatment Considerations

The treatment of Le Fort fractures requires careful consideration of the patient's overall condition, including:

• Associated injuries, such as mandible fractures or traumatic brain injuries 3
• The need for operative management, which may involve surgical fixation or other interventions 3, 6
• The potential for complications, such as nonunion or significant cosmetic issues 2, 4