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A modified minimally invasive Le Fort I approach allowing four-point fixation osteosynthesis using lateral punctiform incisions.

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Τίτλος: A modified minimally invasive Le Fort I approach allowing four-point fixation osteosynthesis using lateral punctiform incisions.
Συγγραφείς: Morand S; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France. Electronic address: sanela.morand@chu-lyon.fr., Morel O; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France., Lange E; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France., Gleizal A; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France.
Πηγή: International journal of oral and maxillofacial surgery [Int J Oral Maxillofac Surg] 2026 Aug; Vol. 55 (8), pp. 956-959. Date of Electronic Publication: 2026 Jan 22.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Churchill Livingstone Country of Publication: Denmark NLM ID: 8605826 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0020 (Electronic) Linking ISSN: 09015027 NLM ISO Abbreviation: Int J Oral Maxillofac Surg Subsets: MEDLINE
Imprint Name(s): Publication: Copenhagen : Churchill Livingstone
Original Publication: Copenhagen : Munksgaard, c1986-
Ιατρικοί όροι (MeSH): Minimally Invasive Surgical Procedures*/methods , Osteotomy, Le Fort*/methods , Fracture Fixation, Internal*/methods , Maxillary Fractures*/surgery, Humans ; Bone Plates
Περίληψη: Surgical techniques in orthognathic surgery have recently evolved and now tend towards soft-tissue-preserving approaches. The concept of minimally invasive Le Fort I osteotomy and down-fracture is interesting, as it preserves almost all paranasal and upper-lip musculature. It has already been described with a four-point fixation on the canine and zygomatic buttress pillars, depending on the mucosal incision length and plate type. This article proposes an alternative technique, respecting the concept of minimally invasive surgery, with a very small medial mucosal incision adding two lateral punctiform incisions, thus enabling a four-point fixation of the Le Fort I fracture. This technique allows wide maxillary movements, significant maxillary expansion; and can be performed even if the surgeon does not have very specific instrumentation. Compared with previously described techniques, this approach offers equivalent surgical exposure, improved access for four-point fixation, and greater safety against mucosal tearing, while maintaining the minimally invasive concept.
(Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
Competing Interests: Competing interests None.
Contributed Indexing: Keywords: Bone plate; Maxillary osteotomy; Minimally invasive surgical procedures; Orthognathic surgery
Entry Date(s): Date Created: 20260123 Date Completed: 20260701 Latest Revision: 20260701
Update Code: 20260702
DOI: 10.1016/j.ijom.2026.01.009
PMID: 41577488
Βάση Δεδομένων: MEDLINE
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  – Url: https://www.doi.org/10.1016/j.ijom.2026.01.009?
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  Data: A modified minimally invasive Le Fort I approach allowing four-point fixation osteosynthesis using lateral punctiform incisions.
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  Data: <searchLink fieldCode="AU" term="%22Morand+S%22">Morand S</searchLink>; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France. Electronic address: sanela.morand@chu-lyon.fr.<br /><searchLink fieldCode="AU" term="%22Morel+O%22">Morel O</searchLink>; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France.<br /><searchLink fieldCode="AU" term="%22Lange+E%22">Lange E</searchLink>; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France.<br /><searchLink fieldCode="AU" term="%22Gleizal+A%22">Gleizal A</searchLink>; MaxilloFacial Surgery Department, Hospices Civils of Lyon, Croix Rousse Hospital, 103 Grande rue de la Croix Rousse, 69004 Lyon, France.
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  Data: <searchLink fieldCode="JN" term="%228605826%22">International journal of oral and maxillofacial surgery</searchLink> [Int J Oral Maxillofac Surg] 2026 Aug; Vol. 55 (8), pp. 956-959. <i>Date of Electronic Publication: </i>2026 Jan 22.
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  Data: English
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Churchill+Livingstone%22">Churchill Livingstone </searchLink><i>Country of Publication: </i>Denmark <i>NLM ID: </i>8605826 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1399-0020 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2209015027%22">09015027 </searchLink><i>NLM ISO Abbreviation: </i>Int J Oral Maxillofac Surg <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: Copenhagen : Churchill Livingstone<br /><i>Original Publication</i>: Copenhagen : Munksgaard, c1986-
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  Data: <searchLink fieldCode="MM" term="%22Minimally+Invasive+Surgical+Procedures%22">Minimally Invasive Surgical Procedures*</searchLink>/<searchLink fieldCode="MM" term="%22Minimally+Invasive+Surgical+Procedures+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Osteotomy%2C+Le+Fort%22">Osteotomy, Le Fort*</searchLink>/<searchLink fieldCode="MM" term="%22Osteotomy%2C+Le+Fort+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Fracture+Fixation%2C+Internal%22">Fracture Fixation, Internal*</searchLink>/<searchLink fieldCode="MM" term="%22Fracture+Fixation%2C+Internal+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Maxillary+Fractures%22">Maxillary Fractures*</searchLink>/<searchLink fieldCode="MM" term="%22Maxillary+Fractures+surgery%22">surgery</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Bone+Plates%22">Bone Plates</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Surgical techniques in orthognathic surgery have recently evolved and now tend towards soft-tissue-preserving approaches. The concept of minimally invasive Le Fort I osteotomy and down-fracture is interesting, as it preserves almost all paranasal and upper-lip musculature. It has already been described with a four-point fixation on the canine and zygomatic buttress pillars, depending on the mucosal incision length and plate type. This article proposes an alternative technique, respecting the concept of minimally invasive surgery, with a very small medial mucosal incision adding two lateral punctiform incisions, thus enabling a four-point fixation of the Le Fort I fracture. This technique allows wide maxillary movements, significant maxillary expansion; and can be performed even if the surgeon does not have very specific instrumentation. Compared with previously described techniques, this approach offers equivalent surgical exposure, improved access for four-point fixation, and greater safety against mucosal tearing, while maintaining the minimally invasive concept.<br /> (Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
– Name: Abstract
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  Data: Competing interests None.
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  Data: <i>Keywords: </i>Bone plate; Maxillary osteotomy; Minimally invasive surgical procedures; Orthognathic surgery
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  Data: <i>Date Created: </i>20260123 <i>Date Completed: </i>20260701 <i>Latest Revision: </i>20260701
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        Value: 10.1016/j.ijom.2026.01.009
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        Text: English
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        StartPage: 956
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        Type: general
      – SubjectFull: Bone Plates
        Type: general
      – SubjectFull: Minimally Invasive Surgical Procedures methods
        Type: general
      – SubjectFull: Osteotomy, Le Fort methods
        Type: general
      – SubjectFull: Fracture Fixation, Internal methods
        Type: general
      – SubjectFull: Maxillary Fractures surgery
        Type: general
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      – TitleFull: A modified minimally invasive Le Fort I approach allowing four-point fixation osteosynthesis using lateral punctiform incisions.
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              Text: 2026 Aug
              Type: published
              Y: 2026
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