The Incidence and Indications for removal of Osteosynthesis Devices in Adult Trauma Patients: A Retrospective Study

Objective: The aim of this retrospective study was to assess the incidence and indications for the removal of bone plates. Study design: Retrospective Study Place and Duration: This study was carried out at the department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences (PIMS) between January 2007 and December 2011. Materials and Methods: The medical records of all patients who underwent removal of bone plates after facial bone trauma were reviewed over a 5-year period. Data concerning age and gender distribution, cause of trauma, time between insertion and removal, indications and site of removal were evaluated for each patient. Results: During the study period, 861 cases underwent open reduction and internal fixation using bone plates and screws. In 51 cases bone plates were removed (46 males and 5 females) with an overall removal rate of 5.9%. The most common indication for removal was infection (51%) followed by pain (23.5%). The mandible was the most common site of removal (60.8%). Most of the plates (90%) were removed within the first year after insertion. Conclusions: Infection was seen to be the most prevalent etiological factor indicating removal. The majority of the cases warranting plate removal were the elderly having comorbid conditions. Removal of plates are more likely to occur within the first year of insertion, effect that should be taken into consideration during the process of obtaining informed consent.