Role of MDCT and 3D computed tomography in the assessment of maxillofacial fractures: A retrospective study in a tertiary care hospital

Background: Maxillofacial trauma is an anatomically complex entity requiring precise radiographic mapping for surgical planning. Conventional radiography usually involves structural superimposition; however, advanced post-processing Multidetector Computed Tomography (MDCT) has emerged as the diagnostic gold standard. The incidence, patterns, and diagnostic markers of fractures in a high-velocity trauma setting using MDCT are evaluated in this study. Methods: A retrospective observational study followed 144 patients with acute maxillofacial trauma in a tertiary care center over a one-year observation period (February 2025-January 2026). All patients underwent non-contrast MDCT examination. The main axial data were processed with Multiplanar Reformations (MPR) and 3D Volume Rendering (VR) on top of the original raw axial data. The fractures were classified by anatomical region and Le Fort classification. Results: The cohort revealed substantial male dominance (78.5%) and a high contribution of Road Traffic Accidents (92.4%). A midface-dominated fracture profile prevailed wherein Orbital (63.2%), Maxillary (54.9%) and Zygomatic (46.5%) fractures predominated whereas Mandibular fractures were less prevalent (15.3%). Le Fort patterns were noted in 28.5% and Le Fort II (48.8%) was more common. Conclusion: High-velocity trauma leads to complex, multi-regional midface injury patterns. MDCT with 3D reconstruction is essential for recognizing intricate ZMC and Le Fort injuries and soft-tissue entrapments missed with traditional imaging.