Abstract
Unfavorable fractures and blood vessel injuries encountered during 196 operations on 185 patients who underwent surgical correction of jaw deformities were studied to analyze the causes. There were 12 unfavorable fractures (6.1%) and 9 blood vessel injuries (4.6%). All complications occurred in two-jaw surgery and sagittal splitting ramus osteotomy (SSRO). Blood loss and operation time were significantly higher in cases with complications than in those without complication in SSRO.
SSRO. With the exception of one case, all fractures were encountered during SSRO. Most of them were minor fractures occurring along the osteotomy line, but relatively large segments of the proximal segment were fractured in 3 cases, 2 of which were not repositioned. Blood vessel injury of the descending palatine artery was encountered in 2 cases of Le Fort I osteotomy. In SSRO, injuries of the inferior alveolar artery, facial artery, and unidentified artery occurred in 3, 1, and 3 cases, respectively. Ligation of the arteries was required to stop bleeding in 2 cases, whereas in the other cases, bleeding was controlled by packing of gauze or oxidized regenerated cellulose.
Insufficient bony cut, forcible splitting, and careless handling of surgical instruments were the main causes of the complications. It is thought that the complications can be avoided by precise analysis of structures at the operation site by computed tomography, sufficient bony cut, and careful handling of surgical instruments.
