Reducing the risk of unfavourable fractures in Le Fort III osteotomy via a navigation-guided technique

The aim of this study was to investigate the clinical feasibility of reducing the risk of unfavourable fractures during Le Fort III osteotomy by using a navigation-guided technique. A study was carried out involving 20 patients with Crouzon syndrome treated with Le Fort III osteotomy and distraction osteogenesis from 2018 to 2023 at the International Hospital of Peking University. The Le Fort III osteotomy procedure in experimental group (9 patients) was carried out under the guidance of navigation technique, while in historical control group (11 patients) was carried out by free hand. Immediate postoperative CT scans were acquired within 24h after surgery to observe the osteotomy lines and detect unfavourable fracture lines. There were 4 patients with unfavourable fractures in the navigation group (4/9 = 44%) while 10 patients in the freehand group (10/11 = 91%), with a statistically significant difference in the probability of unfavourable fracture and the number of fracture lines between the two groups (P < 0.05). The difference in unfavourable fracture incidence in the two groups was significant in zygomatic area (P < 0.05) while not significant in mid-palatal area (P > 0.05). And the surgical duration of the navigation group was significantly shorter than that of the freehand group (216 min vs 280 min) (P < 0.05). The above findings suggest that the navigation-guided technique is effective in reducing the risk of unfavourable fractures in Le Fort III osteotomy procedure and decreasing the surgical duration.