Objectives: Midface fractures, commonly referred to as Le Forte fractures are generally rare fractures; however, it accounts for 10-20% of all facial fractures which could be life-threatening and disfiguring in patients. This study aimed to provide patient characteristics and short-term (30 days) clinical outcomes of Le Forte fractures.
Methods: Using the NSQIP database from 2016-2019, cases with Le Forte fractures were identified by ICD-10 code. We excluded patients under 18 years old and those who underwent elective surgeries. We evaluated patient characteristics and outcomes. Our outcomes include the occurrence of any in-hospital complication, hospital length of stay (LOS), readmission rates, and reoperation rates. All descriptive statistical analyses were performed using SPSS.
Results: Over 4 years, we identified 130 (3.95%) cases of Le Forte fractures from 3,293 facial fractures. 53.8% (70) of patients were diagnosed with Le Forte I, 31.5% (41) of patients with Le Forte II, and 14.6% (19) of patients with Le Forte III. The male-to-female ratio was 4.9: 1 (108: 22). The mean age of patients was 48.22 ± 18.9 years. Compared to geriatric patients (>65 years old), Le Forte fractures were more common amongst patients between the ages of 18-65 (20.8% vs 79.2%, p < 0.003). Most patients underwent facial reconstruction surgery within the first 3 days of admission (95.4%), and 83.8% of patients were discharged in less than 3 days. The median (IQR) hospital length of stay (LOS) was 1 (0 - 2) days. During hospitalization, 5.4% (7) of patients had complications, including sepsis (0.8% [1]), superficial-deep incisional surgical site infection (SSI) (3.07% [4]), and wound disruption (1.5% [2]). Only 1.5% (2) of patients were readmitted for sepsis and SSI, while 2.3% (3) underwent reoperation for debridement.
Conclusion: Patients with Le Forte fractures were most often males in their productive years, presenting with a Le forte I fracture. Compared to previous studies, our study showed less incidence of Le forte fractures from all facial fractures. It also showed a low incidence of in-hospital complications of 5.4%.
