The Removal of Plates after Craniomaxillofacial Surgery: A Retrospective Study.

Purpose: Plate systems have been used for osteosynthesis of cranial and oromaxillofacial fracture. However, there is no consensus on the need for routine removal of plate and the question about indications of removal. Therefore, we present the retrospective study to clarify the indications and consensus of removal.Methods: The medical records of patients who were treated with rigid internal fixation using plates after craniofacial trauma were reviewed. Study variables included age, gender, type of fracture, type of plate, seniority of the operator, causes of removal, and time between insertion and removal. All results amendable to statistics were analyzed using SPSS 10.0 to determine which set of variables might affect the fate of the plates.Results: For a period of 10 years (March 1, 1994 through July 31, 2004), total of 41 plates(6.7%) were removed among 609 plates inserted into 419 patients; 27 plates were removed from 15 patients for infection, which is the most common cause of removal accounting for 65.8%. Mean time between insertion and removal is 35.2 months and mean age is 41.4 years. Most plates were removed from combined fracture(14.92%) and facial fracture(8.47%) and these were statistically significant. The age, gender, seniority of the operator and other variables were not statistically associated with plate removal.Conclusion: This retrospective study shows that routine removal does not appear to be clinically indicated due to respectively low removal rate and that the commonest indications for removal were infection.