Maxillofacial Trauma Surgery Patients With Titanium Osteosynthesis Miniplates: Remove or Not?

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Trauma Surgery

Background:

• Maxillofacial fractures are common injuries requiring surgical intervention.
• Titanium miniplates are frequently used for osteosynthesis in treating these fractures.
• Understanding the optimal timing and reasons for miniplate removal is crucial for patient outcomes.

Purpose of the Study:

• To investigate the timing and causes of titanium miniplate removal following maxillofacial trauma surgery.
• To identify factors influencing the need for miniplate removal.
• To evaluate the safety and long-term utility of titanium miniplates in osteosynthesis.

Main Methods:

• Retrospective study of maxillofacial fracture patients undergoing miniplate insertion or removal.
• Data collected from 2008-2017 at Kagawa Prefectural Central Hospital.
• Analysis of predictive variables including age, sex, fracture site, and time to removal, in relation to complications.

Main Results:

• Out of 185 patients, 440 miniplates were inserted and 272 removed.
• Complications led to the removal of 5.7% of miniplates.
• Mean removal time was significantly longer in patients with complications (630.9 days) versus without (258.0 days).
• Age and sex showed a statistically significant difference in miniplate removal and retention rates.

Conclusions:

• Titanium miniplates are generally safe and effective for long-term osteosynthesis with few complications.
• Complications necessitating removal often occur early (within 1 year) or late (after 5 years) postoperatively.
• Treatment decisions for osteosynthesis should consider patient age and sex, with long-term follow-up recommended for plates implanted over a year.