Effectiveness of Closed Reduction in Pediatric Le Fort I Fractures: A Case Study on Minimally Invasive Management

Pediatric facial fractures, particularly Le Fort I fractures, present unique challenges in diagnosis and management. Le Fort I fractures involve a horizontal fracture of the maxilla, which can result in facial asymmetry, malocclusion, and difficulty in feeding. Closed reduction has been shown to be an effective method for managing these fractures, with minimal long-term effects on growth and development. This case report details the treatment of a 7-year-old male patient who sustained a Le Fort I maxillary fracture following a fall with a pen inside his oral cavity. Key CT findings confirmed a unilateral maxillary fracture with a deviated nasal septum, with no involvement of orbital structures. The patient was managed with closed reduction techniques, including maxillomandibular fixation (MMF), trans-maxillary fixation, and frontal suspension, under general anaesthesia. Postoperative recovery was uneventful, with the patient resuming oral feeding within 4 hours and being discharged after 5 days. Weekly postoperative follow-up was performed regularly, and the patient showed no signs of malunion or infection till the fixation materials were removed after 4 weeks, with no complications or recurrence. This conservative approach was chosen to preserve growth potential and minimise complications, avoiding the need for open reduction and internal fixation (ORIF), given the patient's age and the risk of disrupting facial growth. The case highlights the effectiveness of closed reduction techniques in pediatric fractures, offering a minimally invasive solution that restores functional and aesthetic outcomes. Additionally, closed reduction may reduce the psychological impact of facial trauma by preserving facial appearance. Based on the positive outcome observed, closed reduction is recommended as a first-line treatment for pediatric patients with similar fracture patterns.