If jaw wires are in place, wire cutters must be at your bedside
If you vomit and your jaw is wired, cut the wires and call emergency services immediately
Adequate protein and calcium intake supports bone healing
Wound and sinus care
Keep incisions clean and dry as instructed
Salt water rinses after meals if intraoral incisions present
Avoid sinus-related pressure (no scuba diving, no swimming)
Follow-up schedule
Oral/maxillofacial surgery or plastic surgery in 1–2 weeks
Return visits at 4, 6, and 12 weeks for bone healing and hardware assessment
Ophthalmology follow-up if any eye symptoms at discharge
Seatbelt and protective equipment reminder
Wear your seatbelt on every trip
Helmet use for cycling and motorcycling
Return to emergency department immediately for
New or worsening clear nasal drainage (possible CSF leak)
Fever above 38.3 degrees Celsius or increasing redness/swelling of face
Any decrease in vision, double vision, or new eye pain
Difficulty breathing or swallowing
Change in your bite or jaw alignment
Confusion, worsening headache, stiff neck, or seizure
References
Guidelines and key sources
ACR Appropriateness Criteria
Expert Panel on Neurological Imaging, Parsons MS et al. ACR Appropriateness Criteria Imaging of Facial Trauma Following Primary Survey. Journal of the American College of Radiology. 2022
CT maxillofacial without IV contrast as gold standard
CT head routinely indicated with Le Fort II pattern
Expert Panel on Polytrauma Imaging, Lee JT et al. ACR Appropriateness Criteria Major Blunt Trauma: Update 2025. Journal of the American College of Radiology. 2026
Trauma and surgical society guidelines
Appelbaum RD et al. Antibiotic Prophylaxis in Injury: AAST Critical Care Committee Clinical Consensus Document. Trauma Surgery and Acute Care Open. 2023
No prophylaxis for non-operative closed fractures
Single perioperative dose for ORIF cases
Coccolini F et al. Antibiotic Prophylaxis in Trauma: GAIS, WISE, WSES, AAST, and WSES Guidelines. Journal of Trauma and Acute Care Surgery. 2024
Tunkel AR et al. 2017 IDSA Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clinical Infectious Diseases. 2017
No prophylactic antibiotics for traumatic CSF leak
Pneumococcal vaccination recommended
Key studies
Bellamy JL, Mundinger GS, Reddy SK et al. Le Fort II Fractures Are Associated With Death: A Comparison of Simple and Complex Midface Fractures. Journal of Oral and Maxillofacial Surgery. 2013
Le Fort II independently associated with RR 1.94 for death
2.88-fold increased intracranial injury risk
Limanto CA, Galvez Cabezas K, Saadat GH et al. Age-Related Outcomes in Le Fort Fractures. The American Surgeon. 2023
Associated injury rates (skull fractures 28%, ICH 13%, C-spine 9.8%)
ORIF performed in 73% of cases
Kuhrau C, Easton J, Woodyard De Brito K et al. Safety of Intubation Methods in Patients With LeFort Pattern Facial Trauma. Journal of Craniofacial Surgery. 2025
Nasotracheal intubation equivalent to tracheostomy when performed under direct visualization
Soong PL, Schaller B, Zix J et al. Role of Postoperative Prophylactic Antibiotics in Treatment of Facial Fractures. British Journal of Oral and Maxillofacial Surgery. 2014
No benefit of extending prophylaxis beyond single perioperative dose
Girotto JA, MacKenzie E, Fowler C et al. Long-Term Physical Impairment and Functional Outcomes After Complex Facial Fractures. Plastic and Reconstructive Surgery. 2001
Long-term complications correlate with fracture complexity
Hopper RA, Salemy S, Sze RW. Diagnosis of Midface Fractures With CT: What the Surgeon Needs to Know. Radiographics. 2006
CT technique and Le Fort pattern recognition guide
Rhea JT, Novelline RA. How to Simplify the CT Diagnosis of Le Fort Fractures. AJR. 2005
Pterygoid plate fracture required in all Le Fort types
Infraorbital rim fracture unique to Le Fort II
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.