We present a new technique, the Roman Arch, Keystone Fixation, for the combined, single-stage procedure using Facial Bipartition and Monobloc Distraction Osteogenesis for correction of hypertelorbitism and midface hypopla-sia. This modification offers greater stability to the operative correction and thus improved outcomes while averting the morbidity associated with multiple staged procedures. Patients with Craniofacial Dysostosis may require correction for hypertelorbitism and mid-face hypoplasia.1 Traditionally, these procedures were sequential or staged, and used acute advancement with bone grafting and rigid fixation. We review a series of combined, one-stage Facial Bipartition and Monobloc Distraction procedure using internal devices (Figure 1). We describe the Roman Arch, Keystone Fixation modification to maximize the stability of the bipartition segments and support the vertical load of the distraction forces (Figure 2).
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