An Adjustable Bone Fixation System for Sagittal Split Ramus Osteotomy: Preliminary Report

After sagittal split osteotomy, osteosynthesis for stabilization of the fragments is usually performed by means of rigid or semirigid fixation to avoid maxillomandibular fixation (MMF). Sometimes, this leads to malpositioning of the fragments with resulting 'immediate relapse' or disturbances of the temporomandibular joints (TMJs) such as progressive idiopathic condylar resorption, which is the worst effect. We have therefore developed a new bone fixation system that allows three-dimensional adjustment even after fixation of the fragments. The special configuration of the system avoids intraoperative dislocation of the mandibular condyle. We have used the method successfully in 40 patients, 27 of whom had mandibular retrognathism and 13 of whom had mandibular prognathism. In particular, there has been no evidence of resorptive changes. There were no postoperative complications.