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Titanium osteosynthesis hardware in maxillofacial trauma surgery: to remove or remain? A retrospective study

European Journal of Trauma and Emergency Surgery volume 40, pages 587–591 (2014)Cite this article

Abstract

Introduction

A 5-year retrospective study evaluated the incidence and causes for removal of titanium miniplates.

Material and Methods

The surgical records of 156 patients treated with rigid internal fixation after maxillofacial traumas were reviewed. Study variables included age, sex, site of fracture, site and number of plates, time of plate removal and reasons for plate removal.

Results

Of 384 plates used for fixation, 35 plates (9 %) in 21 patients (13.5 %) were removed due to hardware related complications. Statistical significance (p < 0.01) was observed in mandibular body and parasymphysis fractures with regards to both fracture site location and plate removal rates. Most plates were removed within the first year after placement (p < 0.01). The highest number of fractures were observed in the 20–30 years group (p < 0.01) while most cases of removal were in the 30–40 years group (p < 0.01). Secondary reconstruction/growth facilitation (11/156, 7 %) (p < 0.01) was the main cause of plate removal while infection/wound dehiscence (9/156, 6 %) (p < 0.01) was the main cause for complication related plate removal. A significantly greater number of plates placed via intraoral incisions (p < 0.01) needed removal.

Conclusions

The low incidence of complication related plate removal (7 %) in the mid and upper face in this study suggests that routine removal of asymptomatic titanium miniplates after maxillofacial trauma at these sites may not be beneficial. The high rate of mandibular site complications (19 %) in this study suggests that routine removal of titanium hardware from mandibular sites may be indicated.

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Acknowledgments

No external funding.

Conflict of interest

Z. Pan and P. M. Patil declare that they have no conflict of interest.

Compliance with Ethics Guidelines

An institutional ethical committee approved the study and all patients gave written informed consent.

Institutional review board clearance

IRB clearance obtained.

Author information

Affiliations

  1. Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325000, China

    Z. Pan

  2. School of Dental Sciences, Plot 32 and 34, Sharda University, Greater Noida, Uttar Pradesh, 201308, India

    P. M. Patil

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  1. Z. Pan
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Correspondence to P. M. Patil.

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Pan, Z., Patil, P.M. Titanium osteosynthesis hardware in maxillofacial trauma surgery: to remove or remain? A retrospective study. Eur J Trauma Emerg Surg 40, 587–591 (2014). https://doi.org/10.1007/s00068-013-0348-5

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  • DOI: https://doi.org/10.1007/s00068-013-0348-5

Keywords

  • Osteosynthesis
  • Removal
  • Maxillofacial trauma
  • Complications
  • Titanium miniplate
  • Rigid fixation