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Question

The type of fracture marked with arrow heads in the following figure is 

 

This question was previously asked in
UPSC CMS 2026 Surgery, Gynaecology & Obstetrics, and PSM Question Paper (02-Aug-2026)
The correct answer is

Le Fort I

The correct answer is Le Fort I. A Le Fort I (Guerin or floating palate) fracture is a horizontal fracture above the tooth apices, crossing the lower nasal septum, lateral nasal walls, anterior and lateral maxillary sinus walls and lower pterygoid plates. It detaches the entire tooth-bearing alveolar segment and hard palate from the midface, which is exactly the region the arrows indicate. Clinically the maxilla moves independently on grasping the upper alveolus while the nasal bridge and orbital rims stay fixed, with malocclusion and mobile dentition.

Le Fort II is pyramidal, running through the nasal bridge, medial orbital wall, orbital floor and infraorbital rim, so the nose moves with the maxilla. Le Fort III is complete craniofacial dysjunction through the nasofrontal suture, orbital walls and zygomatic arches, often with CSF rhinorrhoea. Le Fort IV is not part of the original classification and is not an accepted level.

Key point: Le Fort I = floating palate, II = floating maxilla (pyramidal), III = floating face. All three involve the pterygoid plates.

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