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

Maxillofacial trauma occurring shortly after orthognathic surgery has been rarely reported. The authors present a 21-year-old man with mandibular prognathism who underwent Le Fort I osteotomy combined with bilateral sagittal split ramus osteotomy (BSSO). The mandible was stabilized with two 2-hole titanium miniplates placed along the superior border on each side. Eight weeks postoperatively, he sustained high-energy facial trauma in a motorcycle accident, resulting in fractures of the mandibular symphysis, bilateral condyles, and maxilla, but notably no fractures at the osteotomy sites. Open reduction and internal fixation were performed, and his postoperative course was uneventful, with stable occlusion achieved at 6-month follow-up. This case demonstrates that appropriately designed rigid fixation can prevent refracture at osteotomy sites even after early high-energy trauma in the early postoperative period, when bone healing is still incomplete.