Symptomatic plate removal in management of faciomaxillary fractures - our experience in tertiary care hospital of North India.

Dr Onkar Singh; Dr Satyendra Narayan Singh; Dr Ramesh Kumar Sharma; Dr Sunil Gaba

Volume : VIII, Issue : IX, September - 2019

Symptomatic plate removal in management of faciomaxillary fractures - our experience in tertiary care hospital of North India.

Dr Onkar Singh, Dr Satyendra Narayan Singh, Dr Ramesh Kumar Sharma, Dr Sunil Gaba

Abstract :

Background: The use of metallic screws and plates has become the standard of care in the operative management of faciomaxillary fractures. The currently available plates and screws are well tolerated in majority of the patients and are generally not removed unless indicated. The hardware may need to be removed because of subjective discomfort felt by the patient or because of infective complications or because of the hardware getting exposed. The present study was undertaken to determine the incidence of plate removal and to find out the commonest reasons for the plate removal. Materials and Methods: In a prospective cum retrospective study over a period of 18 months, 290 patients were recruited in the study. A total of 1157 plates were placed in these patients at various locations. 39 plates (3.37%) were removed subsequently from 18 patients (6.20%) secondary to objective and subjective reasons. The type (metal) of material used, the number of plates used, the location of the plates, and the route of insertion of the hardware was also studied. The time interval between the placement and removal of the plates was also studied. Results: 1157 plates were placed in 290 facio–maxillary cases operated in this study. 39 plates (3.37%) were removed subsequently from 18 patients (6.20%) secondary to objective and subjective reasons, and majority of plates removed were from the mandible (69.23%).Majority of patients (67.24%) had two to four osteosynthesis plates inserted. The stainless steel plates had a very high rate of plate removal in our study. Conclusion: There will always be a need for hardware removal in a portion of patients treated with metallic osteosynthesis devices. Approximately one in sixteen patients eventually undergo plate removal because of hardware–related objective signs or subjective symptoms.