口内垂直升支截骨术中摆动锯断裂——病例报告
Breakage of Oscillating Saw during Intraoral Vertical Ramus Osteotomy - A Case Report.
作者信息
Ramos Emilio, Grümberg Uriel, Gutierrez Josefina, Pezza Victoria
机构信息
Department of Oral and Maxillofacial Surgery, Dr Cesar Milstein Hospital, Buenos Aires, Argentina.
Department of Oral and Maxillofacial Surgery I, School of Dentistry, University of Buenos Aires (Facultad de Odontologia, Universidad de Buenos Aires), Buenos Aires, Argentina.
出版信息
Ann Maxillofac Surg. 2025 Jan-Jun;15(1):118-120. doi: 10.4103/ams.ams_155_24. Epub 2025 Apr 4.
THE RATIONALE
Oscillating saw breakage during intraoral vertical ramus osteotomy (IVRO) is a rare complication but with potential risk for patients' safety.
PATIENT CONCERNS
This is a case of oscillating saw breakage during an IVRO in a 25-year-old female patient. Attempts were made with different manoeuvres to retrieve the broken blade without success.
DIAGNOSIS
Postoperative Computed Tomography (CT) images showed the broken blade embedded in the upper part of the right vertical ramus osteotomy.
TREATMENT
Six weeks following the initial surgery, the patient underwent a new surgical procedure to extract the saw.
OUTCOME
The broken saw was pushed laterally from the medial aspect of the ramus using a periosteal elevator and retrieved from the lateral aspect of the mandible with curved haemostatic forceps without complications.
TAKE-AWAY LESSONS: To prevent this undesirable event, it is crucial to avoid improper manoeuvres that could overstrain the saw during the osteotomy, as well as oscillating saws with multiple prior uses.
理论依据
在口内垂直升支截骨术（IVRO）过程中摆动锯断裂是一种罕见的并发症，但对患者安全存在潜在风险。
患者关注问题
这是一例25岁女性患者在IVRO手术过程中摆动锯断裂的病例。尝试了不同操作来取出断裂的锯片，但未成功。
诊断
术后计算机断层扫描（CT）图像显示断裂的锯片嵌入右侧垂直升支截骨术的上部。
治疗
初次手术后六周，患者接受了新的手术以取出锯片。
结果
使用骨膜剥离子将断裂的锯从升支内侧向外侧推，并使用弯止血钳从下颌骨外侧取出，未出现并发症。
经验教训
为防止这种不良事件发生，在截骨过程中避免可能使锯过度受力的不当操作以及多次使用过的摆动锯至关重要。
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