Surgical management of bilateral bad split during orthognathic surgery

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Felipe Soto D.
Javiera Cancino G.
Diego Fonseca E.
Renato Gunckel M.
Marcelo Mardones M.

Keywords

bad split, orthognathic surgery, unplanned fracture, sagittal split osteotomy, intraoperative complications

Abstract

Bad Split is a clinical term referring to an unplanned fracture that occurs during the bila­teral sagittal split osteotomy (BSSO). It affects approximately 2,3% of the patients undergoing orthognathic surgery and several risk factors have been described such as the presence of mandibular third molars, advanced age at the moment of orthognathic surgery, inade- quate osteotomy technique, etc. Preventive maneuvers are recommended in order to avoid the appearance of undesired fracture patterns during BSSO. However, if a bad split is detected it must be managed and treated by a qualified team to avoid further complications such as delayed bone consolidation, bone infection and necrosis. In this article we present the management of a case of bilateral bad split by the Maxillofacial Surgery Service of Hospital San José, emphasizing on its surgical treatment.

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