New technique for removing bone covering miniplates and screws.

Abstract

Miniplate osteosynthesis has revolutionised the treatment of open reduction and internal fixation in craniomaxillofacial procedures. However, when complications arise necessitating the removal of previously placed miniplates, bony overgrowth may be present and must be eliminated before removal of the hardware is possible. Osteogenesis over the screws prevents proper engagement of the screwdriver with the screw drives. If bone remains embedded in the screw drive during attempted removal of the screw, the contact interference increases the risk of the screwdriver slipping and the screw drive being stripped. There remains a lack of adequate techniques to clear bony overgrowth from miniplates and screws to allow for easy removal, as conventional methods are ineffective, time-consuming, and may damage the screw drives. Herein, we describe a new laser-assisted miniplate removal technique to eliminate bone that has grown over miniplates and screws before the miniplate is removed. This technique is efficient, safe, and simple and, compared with conventional methods, may decrease the complications associated with the removal of miniplates and screws.