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Related Experiment Video

Updated: May 24, 2026

Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
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Midfacial distraction without osteotomy using a transfacial pin and external devices.

Edouard Coeugniet1, Patrick Dhellemmes, Mathieu Vinchon

  • 1National Center of Caniomaxillofacial Malformations, Plastic Surgery Department, University Hospital Lille, Lille Cedex, France. e_coeugniet@hotmail.com

The Journal of Craniofacial Surgery
|February 17, 2012
PubMed
Summary

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This study introduces a novel midface distraction technique using external pins, avoiding Le Fort osteotomies. This method effectively corrects facial retrusion with reduced complications, offering a safer craniofacial surgery alternative.

Area of Science:

  • Craniofacial Surgery
  • Orthognathic Surgery
  • Pediatric Plastic Surgery

Background:

  • Traditional frontofacial advancement using Le Fort III osteotomy for severe facial stenosis carried significant morbidity.
  • Midfacial distraction techniques were developed to reduce complications by minimizing the gap created during osteotomy.
  • Le Fort III osteotomy creates a large communication between the frontocranial dead space and nasal fossae, leading to potential complications.

Purpose of the Study:

  • To present an innovative midface distraction technique utilizing external distraction frames.
  • To eliminate the need for Le Fort osteotomies in treating midfacial retrusion.
  • To reduce the morbidity associated with traditional craniofacial advancement procedures.

Main Methods:

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  • Seventeen patients with midfacial retrusion and Class III malocclusion were treated between 1997 and 2008.
  • A modified fronto-orbital advancement was performed with vertical cuts to the lateral orbital wall and zygomatic arch only.
  • Distraction was achieved using an external frame anchored with K-wires and a transfacial pin through the maxilla, with horizontal distraction to Class II overcorrection.

    • Main Results:

    • No life-threatening complications or mortalities were observed in the patient cohort.
    • All cases of midfacial retrusion were successfully corrected without evidence of relapse.
    • Most complications arose from overly rapid distraction activation exceeding 1 mm/day.

    Conclusions:

    • Midface distraction with an external transfacial pin is a safe and effective method for correcting significant facial retrusion.
    • This technique allows direct distraction on the maxilla, obviating the need for Le Fort osteotomy.
    • Eliminating major osteotomies significantly decreases severe complications in craniofacial surgery.