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Comparing the Infection Rates of Strut Versus Straight Plates in Sagittal Split Osteotomies.

Stephen E Higgins1, Valmont Desa2

  • 1Resident, Department of Oral and Maxillofacial Surgery, University of Nebraska Medical Center, Omaha, NE.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|March 24, 2025
PubMed
Summary

The type of internal fixation plate used in sagittal split osteotomies did not significantly impact postoperative infection rates. Neither strut nor straight plates showed a higher risk for complications like infection or hardware removal.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Surgical Fixation Techniques

Background:

  • Sagittal split osteotomies are common in orthognathic surgery.
  • Postoperative infection is a significant complication following these procedures.
  • Various internal fixation methods exist, but their comparative efficacy regarding infection is unclear.

Purpose of the Study:

  • To compare postoperative infection rates between strut plates and straight plates used for internal fixation in sagittal split osteotomies.
  • To evaluate the association between plate type and other complications such as hardware removal and neurosensory deficits.

Main Methods:

  • A retrospective cohort study of 112 patients undergoing sagittal split osteotomies.
  • Patients were treated with either strut or straight plates for internal fixation.
  • Outcomes assessed included postoperative infection, hardware removal, and neurosensory function.

Main Results:

  • No statistically significant difference in postoperative infection rates was observed between strut and straight plates (RR 1.23, P < .7).
  • Hardware removal (RR 1.25, P < .5) and 3-month neurosensory disturbance (RR 1.17, P < .7) were also not significantly different between the two plate types.
  • Postoperative infection was the primary reason for plate removal in 10 patients.

Conclusions:

  • The choice between strut and straight plates for internal fixation in sagittal split osteotomies is not associated with a higher risk of postoperative infection.
  • Similarly, hardware removal and neurosensory deficits were not significantly influenced by the type of plate used.
  • These findings suggest that other factors may be more critical in preventing complications after sagittal split osteotomies.