This is a very rare isolated fracture pattern. More often it occurs in combination with other midface fractures (Le Fort I and Le Fort III).
|Non- or minimally mobile Le Fort II fractures with unaffected occlusion in compliant patients with good dentition.|
- Nondisplaced stable fractures with premorbid occlusion in compliant patients
- Edentulous patient with minimal fracture displacement
- General condition of the patient not allowing for surgical intervention
|Non- or minimally displaced fractures in a compliant patient amenable to MMF.|
Fractures with minor malocclusion readily correctable with maxillary manipulation, and not grossly mobile after repositioning may be treated closed. However, closed reduction is more commonly used in conjunction with other stabilization techniques (skeletal suspension, external fixators, etc.).
- Premorbid or unstable medical condition preventing general anesthetic
- Conditions making open reduction and internal fixation difficult
- Patient refusal of operative treatment (eg, for religious/cultural or financial reasons)
- Unavailability of plates and screws
Special consideration: MMF may be contraindicated in patients with psychiatric disorders, seizure disorders, and alcoholics.
|Open reduction internal fixation|
|Displaced Le Fort II fractures resulting in malocclusion or facial deformity.|
Ideally, any displaced Le Fort II fracture should be treated by open reduction and internal fixation.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|