Hardware Removal in Maxillofacial Trauma: A Retrospective Study

Abstract

Background. Miniplates are commonly used for the fixation of maxillofacial fracture segments. Removal of the hardware is controversial. A retrospective study of medical records was performed to observe the reasons for plate removal. Materials and Methods. A 10-year retrospective study of medical records was performed. Demographics, type of fracture, location, type of miniplate used, the time gap between the insertion and removal, and causes of hardware removal were assessed. Results. About 1472 patients had undergone internal fixation for the facial fractures. Stainless steel miniplate was used in 489 patients, and titanium was used in 983 patients. Out of the 42 cases, 22 cases involved the removal of titanium hardware and 20 patients involved the removal of stainless steel hardware. Infection/osteomyelitis was the main cause of hardware removal. The maximum amount of hardware failure was in the mandible. 78.6% of hardware removal was performed in males. Conclusion. Based on our study, routine removal of titanium miniplates can be performed in children to avoid growth disturbances, not indicated in adult patients unless symptomatic.

Risk Factors for Hardware Removal Following Bimaxillary Surgery: A National Database Analysis

“…The past few decades have seen a shift from stainless steel hardware to titanium hardware for the fixation of maxillomandibular fractures due to claims of increased biocompatibility, more physiologic rigidity, improved immunogenicity, and greater resistance to cyclic load. Notably, discourse on titanium’s practical ability to offer enhanced protection against plate failure and other complications remains mixed 1,4,15,32,33 . Over our study period, VSP also arose as a prevalent and lasting tool in the orthognathic surgery landscape, with the first publications on VSP in orthognathic surgery emerging in 2011 and multiplying since then 34 .…”

“…Notably, discourse on titanium's practical ability to offer enhanced protection against plate failure and other complications remains mixed. 1,4,15,32,33 Over our study period, VSP also arose as a prevalent and lasting tool in the orthognathic surgery landscape, with the first publications on VSP in orthognathic surgery emerging in 2011 and multiplying since then. 34 Although VSP consistently demonstrates advantages over traditional surgical planning in operative efficiency and accuracy, conclusions on VSP's ability to reduce postoperative complications remain mixed.…”

“…First, titanium plates have overtaken stainless steel plates as the standard of care for facial fracture fixation. Proponents of this transition have cited several advantages of titanium plates over stainless steel: enhanced biocompatibility, durability, ductility, and lack of interference with medical imaging modalities 4,5,15 . Prior investigations have posited that these characteristics of titanium plates might also reduce rates of ROH relative to stainless steel plates 8 .…”

“…Proponents of this transition have cited several advantages of titanium plates over stainless steel: enhanced biocompatibility, durability, ductility, and lack of interference with medical imaging modalities. 4,5,15 Prior investigations have posited that these characteristics of titanium plates might also reduce rates of ROH relative to stainless steel plates. 8 Second, virtual surgical planning (VSP) has emerged as a popular tool in orthognathic surgery and has become increasingly prevalent due to its potential to improve accuracy and efficiency in jaw repositioning.…”

Kirschner Wire Fixation Versus Mini Plate Fixation in Multiple Metacarpal Shaft Fractures of Hand to Compare Early Range of Motion in Hand

“…There is also a risk of plate and screw loosening or breakage, which can require further surgery. In addition, the use of metal implants can interfere with imaging studies, making it difficult to assess healing progress or detect complications [23][24] .…”