Incidence of Plate Removal and its Correlation to the Site of Injury in Patients with Maxillofacial Trauma: A Retrospective Study

Abstract

Background: Maxillofacial injuries can be classified according to its anatomical location of the involved bone and by the degree of involvement like simple, compound or comminuted. Regardless of the site of involvement and nature of trauma the fracture can be addressed by closed and open methods of reduction. Objective: The aim of this retrospective study was to record the incidence and factors associated with plate removal in patients with maxillofacial trauma. Materials and Methods: Records of 280 cases managed for maxillofacial trauma in the last (5 years) period from January 2010 to Dec 2014 by open reduction and internal fixation (ORIF) with osteosynthesis plates were analyzed at a tertiary health care facility. Logistic regression analysis was done to find an association between the variables studied and incidence of plate removal. Results: 32 cases (11.42%), 55 number of implants underwent removal of plates due to reasons ranging from infection(50%), Plate exposure(9.375%), treatment failure(15.625%), palpability(12.50%), and persistent pain(12.50%), Zygomatic buttress and Parasymphysis sites had highest incidence of plate removal compared to other sites. Being a female [OR 9.87(4.21–10.72)], age groups of 46-60 [OR 6.39(4.43-9.62)], 31-45 [OR 11.25(6.81-13.77)] and 15-30 [OR 10.01(5.74-12.22)], infra orbital rim among sites [OR 2.03 (1.48-4.67)] significantly increased the odds of incidence of plate removal. Conclusion: In our retrospective analysis, the overall incidence of plate removal was 11.42%. Maximum plate removals were from Zygomatico-Maxillary Buttress and Symphysis and Parasymphysis regions. Infection was found to be the most common cause of plate removal.