Maxillofacial Fractures After Le Fort I and Bilateral Sagittal Split Osteotomy Using Two 2-Hole Miniplate Fixation

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Orthognathic Surgery

Background:

• Maxillofacial trauma post-orthognathic surgery is uncommon.
• Patients undergoing orthognathic surgery are at risk for facial trauma.
• Understanding fixation stability is crucial for patient outcomes.

Purpose of the Study:

• To report a rare case of severe maxillofacial trauma after orthognathic surgery.
• To evaluate the effectiveness of rigid fixation in preventing osteotomy site refracture.
• To assess the management and outcomes of such injuries.

Main Methods:

• A 21-year-old male with mandibular prognathism underwent Le Fort I and bilateral sagittal split ramus osteotomy (BSSO).
• Mandibular stabilization was achieved using dual 2-hole titanium miniplates per side.
• The patient experienced high-energy facial trauma 8 weeks postoperatively.

Main Results:

• The trauma resulted in mandibular symphysis, bilateral condyle, and maxillary fractures.
• Crucially, no refractures occurred at the previously operated osteotomy sites.
• Open reduction and internal fixation of new fractures led to an uneventful recovery.

Conclusions:

• Appropriate rigid fixation provides significant stability to osteotomy sites.
• Rigid fixation can prevent refracture even with early, high-energy maxillofacial trauma.
• This approach ensures stable occlusion and successful healing post-trauma.