Utility of the LeFort I Osteotomy in the Acute Management of Midface Trauma
Bibliographic record
Abstract
PURPOSE: Pure and isolated LeFort I, II, and III fractures are rare. Typically, they occur at different levels on each side and may be incomplete in nature, which complicates management. The LeFort I osteotomy is a well-described technique in elective management of midface deformities. However, there is minimal literature on its use in acute trauma. This study describes the use of the LeFort I osteotomy as a surgical maneuver to aid in the reduction of complex midface fractures and the re-establishment of premorbid occlusion. METHODS: A retrospective review was performed of all consecutive midface fractures managed at our center from 2008 to 2020. The inclusion criteria were adult patients who had a LeFort I osteotomy in the setting of acute fracture management. Primary outcomes were the long-term stability of fracture fixation and the re-establishment of stable, reproducible occlusion at follow-up. RESULTS: Twenty-two cases met the criteria for inclusion. The most common indication was contralateral LeFort I and ipsilateral incomplete or absent LeFort I (50%). Most remaining cases had a high LeFort (II or III) on the ipsilateral side and a high LeFort I on the contralateral side (41%). There was one case of nonunion requiring revision and bone grafting. In all remaining cases who presented for follow-up at an average of 1.5 years, stable, reproducible occlusion was achieved. CONCLUSIONS: In acute trauma, a LeFort I osteotomy is a safe and effective technique to re-establish premorbid occlusion when passive reduction of the maxilla cannot be achieved. This technique can be safely added to the armamentarium of any surgeon who manages acute craniofacial trauma.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".