A unique indexing splint for use in combined Le Fort and nasal injuries to avoid tracheostomy. Midface fractures with associated displaced and/or comminuted nasal fractures can require tracheostomy for a general anesthetic airway if these fractures are to be reduced simultaneously. We describe a unique indexing splint that allows oral intubation yet also allows simultaneous reduction of midface and nasal fractures under one anesthetic. Furthermore, tracheostomy with its potential complications is avoided. The case report illustrates the technique, and alternative treatments for these injuries are discussed. 