Summary
Background
Titanium-based plates used to repair facial fractures are sometimes removed despite
their high biocompatibility. Local discomfort can lead to plate removal surgery. Local
discomfort may differ according to patient characteristics, tissue properties and
plate thickness; however, little is known about the relationship between these conditions
and plate removal.
Methods
We performed a hospital-based, retrospective cohort study of patients who underwent
internal fixation for facial or frontal bone fracture. To identify factors associated
with plate removal, we used multivariate logistic regression models.
Results
Data from 138 patients were analysed. All plates were made of commercially pure titanium,
and all screws were made of titanium, 6% aluminium and 4% vanadium alloy. Plate thickness
was 1.2 mm or 0.6 mm. Among plate locations, the frontozygomatic suture showed the
highest percentage of complications (84%, 86 of 102 patients). The majority consisted
of palpability and visibility. In patients who underwent plate removal (n = 96), all plates and screws were removed successfully. All plate-related complications
were resolved after plate removal. No complications were introduced by plate removal.
Plates 1.2 mm in thickness on the frontozygomatic suture had a relative risk of complications
2.48 times (95% confidence interval, 1.13–5.43) that of plates 0.6 mm in thickness.
By multivariate analysis, the presence of plates on the frontozygomatic suture was
a significant and independent risk factor for removal. Patients with plates on the
frontozygomatic suture had a risk of plate removal 3.95 times (95% confidence interval,
1.55–10.07; P < 0.01) that of patients without plates on the frontozygomatic suture.
Conclusion
Plates on the frontozygomatic suture have a high rate of complications. Thick plates
increase these risks. Patients with plates on the frontozygomatic suture are more
likely to undergo plate removal surgery than patients without plates on the frontozygomatic
suture.
Keywords
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Article info
Publication history
Published online: October 26, 2011
Accepted:
September 27,
2011
Received:
March 30,
2011
Footnotes
☆Part of this work was presented at the 26th Annual Meeting of the Japan Society of Cranio-Maxillo-Facial Surgery, Morioka, Japan, 17 October 2008.
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
