The Effects of Plate and Screw Fixation on the Growing Craniofacial Skeleton

Abstract

The plate and screw fixation of surgically created and repositioned osteotomies or reduced fracture segments has revolutionized the practice of adult craniomaxillofacial surgery. The superior results obtained with rigid fixation techniques has prompted its use in the pediatric population.1,2 Plate and screw stabilization of reshaped and repositioned bone units and bone grafts may have certain advantages over no stabilization or interfragmentary wire stabilization. Posnick has listed the potential advantages of miniaturized plate and screw fixation techniques for pediatric craniofacial surgery.3 These advantages may include: 1. Improved three-dimensional shape control of refashioned osteotomized segments 2. Improved three-dimensional position control due to prevention of osteotomy or bone graft collapse after soft tissue closure 3. Facilitation of bone healing 4. The need for fewer drill holes when plates are used rather than interfragmentary wires 5. Decreased bone segment mobility, which may decrease resorption and infection rates and may also obviate the need for protective head gear 6. Elimination of the “sharpwire” pain that may accompany the use of interfragmentary wires under thin areas of the skin