title: National hardware removal rate associated with internal fixation of facial fractures.
abstract: OBJECTIVE
  There has not been a broad national examination of complications and demographics of facial trauma reduction procedures. The literature has reported acceptable and unacceptable hardware removal rates in localized populations.
  
  
  METHODS
  The 2007 Nationwide Inpatient Sample was used to determine all plate removal procedures associated with common complications from facial reductions. Statistical analysis was used to compare the differences in demographics of the reduction procedure and removal procedure groups.
  
  
  RESULTS
  Some form of open fixation was reported in 4,879 patients. Plate removals associated with complications were reported in 246 patients. The "failure" removal rate as a percentage of the total number of open procedures for the year was 5.0%. Gender, race, age, primary payer, and median income of the patient were determined to significantly affect the likelihood for hardware removal due to complications.
  
  
  CONCLUSIONS
  These results suggest that decreased lower bone quality and ability to pay affect the chances that a particular patient will undergo a hardware removal procedure. There is a strong possibility that the reported removal rate underestimates the actual failure rate of the procedures and devices used to treat facial trauma.
authors.affiliation: PhDx Systems, Inc, 1001 University Blvd SE, Suite 103, Albuquerque, NM 87106, USA. jhanson@phdx.com
authors.forename: Jean
authors.initials: J
authors.lastname: Hanson
authors.forename: Scott
authors.initials: S
authors.lastname: Lovald
authors.forename: Ian
authors.initials: I
authors.lastname: Cowgill
authors.forename: Meghan
authors.initials: M
authors.lastname: Erdman
authors.forename: Beverly
authors.initials: B
authors.lastname: Diamond
mesh_terms: D000328:Adult; D000367:Age Factors; D001860:Bone Plates / Q000706:statistics & numerical data*; D020878:Device Removal / Q000706:statistics & numerical data*; D004868:Equipment Failure / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016013:Likelihood Functions; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008337:Mandibular Fractures / Q000601:surgery; D008440:Maxillary Fractures / Q000601:surgery; D011183:Postoperative Complications / Q000145:classification; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data; D012737:Sex Factors; D012887:Skull Fractures / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014481:United States; D014504:Urban Health / Q000706:statistics & numerical data; D015051:Zygomatic Fractures / Q000601:surgery