Identification and classification in le fort type fractures by using 2D and 3D computed tomography

Objective： To evaluate the usefulness of twodimensional （2D） and three-dimensional （3D） computed tomography （CT） in the identification and classification of Le Fort type fractures. Methods： Sixty-two patients with different types of Le Fort fractures underwent CT scanning and 3D-CT reconstruction. The data were analyzed by multiplanar reconstruction （MPR）, surface shaded display （SSD） and volume rendering （VR） respectively. Results： The patients with Le Fort Ⅰ , Le Fort Ⅱ fracture and Le Fort Ⅲ fracture accounted for 16.1%, 14.5% and 12.9% respectively. The compound fractures were the most common type and accounted for 56.5 % （ n = 35, 18 cases with Le Fort Ⅰ ＋ Ⅱ fracture, 10 cases with Le Fort Ⅱ ＋Ⅲ fracture and 7 cases withLeFort Ⅰ ＋ Ⅱ ＋Ⅲ fracture）. Fifty-five cases coexisted with other fractures in maxillofacial region. 2D-CT could be used to define the tiny fractures and the deep-structure fractures more accurately compared with 3D-CT, but the real impression of Le Fort type fractures could not be correctly evaluated on 2D-CT. 3D-CT could clearly demonstrate the whole shape of Le Fort type fractures and identify the classification of Le Fort fractures. Conclusions： 3D-CT is the best imaging method for the diagnosis of Le Fort type fractures and can provide valuable information of space relationship, especially for the design of treatment plan before operation.