The history of the “Le Fort I osteotomy”

doi:10.1016/S0301-0503(86)80275-2

Journal of Maxillofacial Surgery

Volume 14, 1986, Pages 119-122

https://doi.org/10.1016/S0301-0503(86)80275-2 Get rights and content

Summary

The history of temporary mobilisation of the upper jaw is described. The operation was first described 130 years ago for removal of a nasopharyngeal tumour. The maxilla was split at the level now known as a Le Fort I osteotomy. A further 80 years elapsed before this operation became part of the surgical treatment of skeletal deformities of the face.

References (54)

AxhausenG.
Zur Behandlung veralteter disloziert verheilter Oberkieferbrüche
Dtsch. Zahn-, Mund- u. Kieferheilk.
(1934)
AxhausenG.
Über die korrigierende Osteotomie am Oberkiefer
Dtsch. Z. Chir.
(1936)
AxhausenG.
Die operative Orthopädie bei den Fehlbildungen der Kiefer
Dtsch. Zahn-, Mund- u. Kieferheilk.
(1939)
AxhausenG.
Technik und Ergebnisse der Lippenplastik
(1941)
BierA. et al.
Chirurgische Operationslehre
(1914)
BierA. et al.
Chirurgische Operationslehre
(1917)
BorchardtM.
Zur temporären Aufklappung beider Oberkiefer
Zbl. Chir.
(1908)
CerneaP. et al.
Les osteotomies totales des maxillaires supérieurs
Rev. Stomat.
(1955)
CheeverD.W.
Naso-pharyngeal Polypus, attached to the Basilar Process of Occipital and Body of the Sphenoid Bone successfully removed by a Section, Displacement, and subsequent Replacement and Reunion of the Superior Maxillary Bone
Boston Med. Surg. J.
(1867)
ConverseJ.M. et al.
Treatment of developmental malformations of the jaws
Plast. reconstr. Surg.
(1952)

CuparI.

Die chirurgische Behandlung der Form- und Stellungsveränderungen des Oberkiefers

Öst. Z. Stomat.

(1954)

De HallerCh.

Ergebnisse des operativen Vorbringens des Oberkiefers

Diss.

(1969)

Dieffenbach, v.: (cit. b. Lanz...

DingmanR.O. et al.

The treatment of malunited fractures of the facial bones

Plast. reconstr. Surg.

(1951)

Le Fort

Fractures de la machoire superieure

Rev. Chir.

(1901)

GilliesH.G.

The Principles and Art of Plastic Surgery

(1957)

GilliesH. et al.

L' osteotomie du maxillaire superieur envisagée essentiellement dans les cas de bec-de-lievre totale

Rev. Stomat.

(1954)

HertleJ.

Über einen Fall von temporärer Aufklappung beider Oberkiefer nach Kocher zum Zwecke der Entfernung eines groβen Nasenrachenfibromes

Arch. klin. Chir.

(1904)

HogemanK.E. et al.

Die Vorverlagerung des Oberkiefers zur Korrektur von Gebiβanomalien

KocherT.

Chirurgische Operationslehre

(1897)

KocherT.

Ein Fall von Hypophysis — Tumor mit operativer Heilung

KönigF. et al.

Die Operationen am Gesichtsteil des Kopfes

LangenbeckB.v.

Die Uranoplastik

Arch. klin. Chir.

(1861)

LanzO.

Osteoplastische Resektion beider Oberkiefer nach Kocher

LevignacJ.

Traitement d'un enfoncement consolide du tiers moyen de la face par osteotomies et greffes d'os

Rev. Stomat.

(1958)

LoeweL.

Weitere Mitteilungen über die Ausräumung der Nase vom Munde her

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^*: R. B. Drommer, M.D., D.M.D. University of Heidelberg Dept. of Maxillofacial Surgery Hospitalstrasse 1 D-6900 Heidelberg

View full text

The history of the “Le Fort I osteotomy”

Summary

Zur Behandlung veralteter disloziert verheilter Oberkieferbrüche

Dtsch. Zahn-, Mund- u. Kieferheilk.

Über die korrigierende Osteotomie am Oberkiefer

Dtsch. Z. Chir.

Die operative Orthopädie bei den Fehlbildungen der Kiefer

Dtsch. Zahn-, Mund- u. Kieferheilk.

Technik und Ergebnisse der Lippenplastik

Chirurgische Operationslehre

Chirurgische Operationslehre

Zur temporären Aufklappung beider Oberkiefer

Zbl. Chir.

Les osteotomies totales des maxillaires supérieurs

Rev. Stomat.

Naso-pharyngeal Polypus, attached to the Basilar Process of Occipital and Body of the Sphenoid Bone successfully removed by a Section, Displacement, and subsequent Replacement and Reunion of the Superior Maxillary Bone

Boston Med. Surg. J.

Treatment of developmental malformations of the jaws

Plast. reconstr. Surg.

Die chirurgische Behandlung der Form- und Stellungsveränderungen des Oberkiefers

Öst. Z. Stomat.

Ergebnisse des operativen Vorbringens des Oberkiefers

Diss.

The treatment of malunited fractures of the facial bones

Plast. reconstr. Surg.

Fractures de la machoire superieure

Rev. Chir.

The Principles and Art of Plastic Surgery

L' osteotomie du maxillaire superieur envisagée essentiellement dans les cas de bec-de-lievre totale

Rev. Stomat.

Über einen Fall von temporärer Aufklappung beider Oberkiefer nach Kocher zum Zwecke der Entfernung eines groβen Nasenrachenfibromes

Arch. klin. Chir.

Die Vorverlagerung des Oberkiefers zur Korrektur von Gebiβanomalien

Chirurgische Operationslehre

Ein Fall von Hypophysis — Tumor mit operativer Heilung

Die Operationen am Gesichtsteil des Kopfes

Die Uranoplastik

Arch. klin. Chir.

Osteoplastische Resektion beider Oberkiefer nach Kocher

Traitement d'un enfoncement consolide du tiers moyen de la face par osteotomies et greffes d'os

Rev. Stomat.

Weitere Mitteilungen über die Ausräumung der Nase vom Munde her