Infections associated with locking reconstruction plates: a retrospective review.
OBJECTIVE
In this study, we examined the incidence of infection with the use of a locking reconstruction bone plate/system.


METHODS
All patients, treated with a locking reconstruction bone plate/screw system for mandible fractures in the Oral and Maxillofacial Surgery service over a 28-month period at a level I trauma center, were evaluated through a retrospective chart review by independent examiners. The use of a locking reconstruction plate was determined by the attending staff involved in the patient's care. Patient population included single, bilateral, and comminuted fractures. Patient characteristics were noted and include dentate versus edentulous, smoking history, and history of previous infection.


RESULTS
Fifty-six locking bone plates were placed in 42 patients. Eight (19%) of the patients were infected before treatment. A persistent infection remained in 3 of these 8 patients (37.5%). Two patients (5.8%), with 3 fracture sites (6.4%) developed postoperative infection that required further intervention. All 5 of the patients who were infected after surgery were heavy smokers. History of preoperative infection and smoking appear to be significant factors in the etiology of postoperative infection. All postoperative infections resolved successfully with local measures and with no loss of fixation.


CONCLUSIONS
The use of locking reconstruction plates can facilitate the management of complicated fractures; however, it does not eliminate complications. Postoperative infections are related to numerous factors, including preoperative incidence of infection, smoking, and proper use of the plates.
Kirkpatrick
David
D
College of Dentistry, University of Kentucky, Lexington, KY 40536, USA.
Gandhi
Rahul
R
Van Sickels
Joseph E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects*; D001863:Bone Screws / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D018460:Fractures, Comminuted / Q000601:surgery; D006801:Humans; D019248:Jaw Fixation Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D008297:Male; D008334:Mandible / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013530:Surgical Wound Infection / Q000209:etiology*