Is the Routine Removal of Titanium Plates and Screws Following Miniplate Osteosynthesis of Maxillofacial Bone Fractures Justified? A Fifteen-Year Experience in a Maxillofacial Centre, Saudi Arabia

Abstract

Background Routine removal of titanium miniplates in the maxillofacial region is still controversial. This current study hopes to share our experience with the different reasons for maxillofacial plates and screws removal following miniplate osteosynthesis. Methods This was a retrospective study of plates and screws removal following Open Reduction and Internal Fixation (ORIF) of maxillofacial fractures at King Khalid Hospital, Kingdom of Saudi Arabia, from 2005-2019. Information collected includes demographics, etiology and pattern of maxillofacial fractures, treatment modalities as well as reasons for plates and screws removal. Data was stored and analyzed using IBM SPSS Statistics for windows Version 25 (Armonk, NY: IBM Corp). Results A total of 985 patients with maxillofacial bone fractures had ORIF during the study period out of which 149 had miniplates and screws removed, giving a prevalence rate of 15.1%. There were 141 (94.6%) males and 8 (5.4%) females, with a M:F of 17.6:1. Their ages ranged from 4-65 years with mean (SD) at 24.6 (12.2) years. The age group from 16-30 years had the most cases of plates removal with statistical significance ( P = .000). Young age (43 (28.8%)) constituted the majority of reasons responsible for plate removal. The angle of the mandible is the site with the largest number of plate removal with 34 (22.8%) cases followed by the parasymphyseal site with 21 (14.1%) cases. Conclusion With removal rate of 15.1%, this study concluded that there is no evidence to support routine removal of asymptomatic plates and screws in maxillofacial region.