Morbidity by plating in maxillofacial surgery.

BACKGROUND

Aim of this paper is to define the behaviour of osteosynthesis plates in maxillofacial area and to determine when to remove them.

METHODS

The records of 123 patients treated with osteosynthesis plates were retrospectively assessed. Each case had a follow-up of not less than 5 years. Removal as a consequence of poor surgery was excluded from the study.

RESULTS

Osteosynthesis occurred in the mandible in 198 cases and in the upper maxilla in 146 cases, with a further 23 cases treated by plating in other sites. Plates were removed in 21 cases; the most frequent cause of removal was infection (13 sites) followed by nerve palsy and dehiscence.

CONCLUSIONS

Infections are without doubt the main cause of plate removal. In orthognathic patients, infections occurred less frequently, nevertheless they remain the main complication. Dysesthesia, along with infections, are the most frequent cause of removal. Plate exposure very rarely are reduction and fixation lost; thus the removal of the plate can be delayed.