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Le Fort II fracture. The 3-dimensional reconstruction computed tomographic scan (Figure 2) showed a Le Fort II fracture, fracture on both sides through the orbital floor (Figure 2, arrow 2), and also through the bridge of the nasal bone (Figure 2, arrow 1). The separated part is triangular or pyramidal in shape, with mobility of the nose. There was also a fracture line on both sides through the maxilla into the nasal cavity, but the nasal septum was intact. A Le Fort I fracture consists of a horizontal fracture of the alveolar process of the maxilla, through the nasal septum. A Le Fort III fracture consists of a horizontal fracture through the orbits with complete separation of the maxilla from the craniofacial skeleton. In comparison to recent pictures of the patient, there was minimal dislocation of the fracture. An external fixture was not placed because of a very poor dental state, and the fracture was treated without any surgery. Images in Emergency MedicineAnnals of Emergency MedicineVol. 45Issue 5PreviewA 61-year-old man was riding his bike when the frame broke and he launched forward and landed on his face. He did not sustain any loss of consciousness. His vital signs were stable and his airway was patent. On physical examination, the patient had several facial lacerations and a nosebleed (Figure 1). The mandible was not dislocated and was nontender on palpation. On further examination, the maxilla could be moved laterally, also demonstrating mobility of the nose. Full-Text PDF