A review of rare palatal fractures and their management

Objective: The objective of this study was to diagnose rare palatal fractures and to subcategories them to formulate a definitive treatment plan depending upon the fracture lines. Materials and Methods: All patients presenting in triage with palatal fractures were classified after computed tomography scan. Thirteen patients diagnosed with complex and transverse palatal fractures were included in the study. Complex fracture was further subdivided into five groups: (a) comminuted, (b) oblique, (c) S shaped, (d) C shaped, and (e) T shaped. The patients were divided into two groups. In Group A, six patients were managed without palatal vault plating, and in Group B, seven patients were managed with palatal vault plating along with anterior alveolar and anterior maxillary buttress plating. Results: Twelve patients presented with complex fracture and one patient presented with transverse fracture. The male-to-female ratio and age range of the study were 5.5:1 and 15–55 years, respectively.Le Fort I and II fracture was present in five patients, isolated Le Fort II fracture in four patients, Le Fort I was present in two, and Le Fort I, II and III fractures was present in two patients. Conclusion: Complex palatal fractures can be subcategorized which simplifies the management and documentation of the fracture. Palatal vault plating should be attempted in cases where there are two large fracture segments to achieve the better stability of fracture and reduce the duration of maxillomandibular fixation in postoperative period.