Background. The long term management of miniplate fixation osteosynthesis remains debatable and controversial with few authors advocating routine removal of the miniplates after 3-6 months of placement, while others recommend retention of the miniplates unless their removal is clinically indicated.
Objective. The aim was to study the incidence, indications, time gap, role of metallic composition and site of removal of miniplates in operated cases of maxillofacial region over a two-year period.
Methods. Patients undergoing removal of miniplates over 2-year period were studied and evaluated regarding the number of miniplates removed, time gap present between fixation and removal of miniplates, indications for removal, metallic composition of miniplates removed, sites of removal and complications. Correlations between indications for miniplate removal based upon time gap, metallic composition, age group and number of miniplates present were determined using Chi-square test. Correlation between metallic composition of miniplate and time gap was also determined using Chi-square test.
Results. The miniplates were removed in 20 patients (16 males and 4 females). Most common indication for removal was infection (45%). Forty-five percent of the patients underwent miniplate removal within 1 year of placement. Thirty-four miniplates and 118 screws were removed. The correlation between indications for miniplate removal and time gap was found to be statistically significant (P = 0.04).
Conclusion. Most of the hardware removal is performed subsequent to complications associated with hardware and local factors play more important role than metallic composition. Routine asymptomatic miniplates do not require removal and is not recommended.
The evolving role of physical therapists in the long-term management of chronic low back pain: longitudinal care using assisted self-management strategies
