Complications of internal fixation of maxillofacial fractures with microplates.
OBJECTIVE
The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates.


METHODS
In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction and internal fixation using a 1.0-mm and 1.5-mm microsystem. Simultaneously occurring fractures of the mandible or frontozygomatic suture were treated with a 2.0-mm miniplate system. Perioperative and postoperative complications were traced using patient charts, operation reports, and radiographs. The average follow-up was 46.8 months (range, 31 to 54 months).


RESULTS
A total of 124 1.0-mm microplates and 546 1.0-mm microscrews, and 17 1.5-mm microplates and 75 1.5-mm microscrews, was used. The perioperative complication rate was 1.2% for the 1.0-mm screws (use of four emergency screws, breakage of one screw in the dense frontozygomatic suture area, and an insertion of a screw in a premolar root). The postoperative complication rate was 0.8% for the 1.0-mm screws (screw dislocation without clinical implication). No complications were observed with the 1.5-mm system. Plate-related infection did not occur. All fractures healed well. Three patients asked for plate removal because of a vague, persisting pain in the treated area. After removal, only one patient was free of pain. A loose 1.5-mm screw was found in this patient.


CONCLUSIONS
The overall complication rate for microsystems was 2.0%. Both microsystems proved to be a reliable modality to fix fractures of the maxillofacial skeleton. Complications can be considered incidental and of neglectable clinical significance.
Schortinghuis
J
J
Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands.
Bos
R R
RR
Vissink
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects*; D001863:Bone Screws; D002648:Child; D004867:Equipment Design; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation; D017102:Fracture Healing; D005626:Frontal Sinus / Q000293:injuries / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D007572:Jaw Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D015051:Zygomatic Fractures / Q000601:surgery