A simplified technique for percutaneous rigid fixation of sagittal ramus osteotomies.

Abstract

Fixation and stabilization of the proximal segment following sagittal ramus osteotomy has received considerable attention in the literature. Techniques vary from wire fixation to rigid fixation using bicortical or lag screw techniques. Wire osteosynthesis techniques include the upper border wire as suggested by Epker’ and the inferior border wire as suggested by Booth.2 According to Jeter et a1,3 conventional wire fixation of a sagittal split osteotomy of the mandible has been associated with more than 50% relapse. Recently, techniques to rigidly fix the proximal and distal segments using bicortical bone screws have been advocated by Spiess14 and Jeter et a1.3 Advantages of rigid fixation include more rapid healing al. the osteotomy,5 early or immediate return to function, elimination of proximal segment rotation, and decreased potential for relapse.6 Neurosensory disturbances following rigid fixation of the sagittal ramus osteotomy are no greater than when nonrigid fixation is used.7 The purpose of this article is to describe a simplified technique for percutaneous bicortical screw fixation of the proximal and distal segments following sagittal ramus osteotomies. The technique uses readily available materials, is adaptable to most commercially available screw systems, and allows the operator excellent control of the proximai segment during the fixation phase.