title: Symptomatic plate removal after treatment of facial fractures.
abstract: OBJECTIVE
  To identify the rates and reasons for plate removal (PR) among patients treated for facial fractures.
  
  
  METHODS
  A retrospective review of files of 238 patients.
  
  
  RESULTS
  Forty-eight patients (20.2%) had plates removed. The reason for removal was objective in 33.3% and subjective in 29.2%. The most common subjective reason was cold sensitivity, and the most common objective reason was wound dehiscence/infection. Women had PR for subjective reasons more often than men (p=0.018). Removal was performed more often for subjective reasons after zygomatico-orbital fractures than after mandibular fractures (p=0.002). Plates inserted in the mandible from an intraoral approach were removed more frequently than extraorally inserted mandibular plates, intraorally inserted maxillary plates, and extraorally inserted plates in other locations (p<0.001). Orbital rim plates had a higher risk of being removed than maxillary or frontal bone plates (p=0.02).
  
  
  CONCLUSIONS
  Subjective discomfort is a notable reason for PR among Finnish patients, suggesting that the cold climate has an influence on the need for removal. Patients receiving mandibular osteosynthesis with miniplates from an intraoral approach are at risk of hardware removal because of wound dehiscence/infection and loose/broken hardware, reminding us that more rigid fixation devices should not be forgotten despite the widespread use of miniplates.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland. hanna.thoren@helsinki.fi
authors.forename: Hanna
authors.initials: H
authors.lastname: Thorén
authors.forename: Johanna
authors.initials: J
authors.lastname: Snäll
authors.forename: Eeva
authors.initials: E
authors.lastname: Kormi
authors.forename: Christian
authors.initials: C
authors.lastname: Lindqvist
authors.forename: Liisa
authors.initials: L
authors.lastname: Suominen-Taipale
authors.forename: Jyrki
authors.initials: J
authors.lastname: Törnwall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects; D016009:Chi-Square Distribution; D002648:Child; D020878:Device Removal; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D012887:Skull Fractures / Q000601:surgery*; D018709:Statistics, Nonparametric; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013697:Thermosensing; D055815:Young Adult