Primary temporary AO plate reconstruction of the mandible

Objective. This study assessed the incidence of complications and revisions after primary temporary AO plate reconstructions of the mandible performed from 1971 through 1996. Study design. In a retrospective record review, the data of 51 patients und ergoing primary temporary AO plate reconstructions after composite mandibul ar resection were analyzed according to age, gender, date of reconstruction , anatomic location of reconstruction, use of additional radiotherapy and/o r flap surgery, and incidence of associated complications and revisions. Results. Associated complications and revisions accompanying primary tempor ary AO plate reconstructions were evaluated through use of the incidence ra tes of associated complications (IACs) and revisions (IARs), which are repo rted as the numbers of associated complications and revisions, respectively , per 100 patients. Of the entire sample, the highest incidence rate of ass ociated complications was associated with infection (33.5); this was follow ed by the rates for plate exposure (27.9) and plate fracture (10.7). With a n overall incidence rate of 38.3 revisions per 100 patients, the correspond ing site-related incidence rates of associated revisions were found to be 5 5.0 for reconstructions of the anterior mandible crossing the midline, 37.1 for those of the body segment of the mandible, and 31.1 for reconstruction s involving the ramus and/or condyle area of the mandible. Revision rates w ere observed to be significantly higher in irradiated (53.6 vs 31.5) and no n-flap-added reconstructions (43.2 vs 24.8). Analysis of treatment group-re lated incidences revealed irradiated non-flap-added reconstructions to be a ssociated with the highest failure rates, whereas additional flap surgery r esulted in a significant reduction in complications (50.0 vs 108.0) and rev isions (20.0 vs 65.7). Conclusions. This study showed primary temporary AO plate reconstructions a fter composite mandibular resection to be associated with a high rate of co mplications and revisions. The results emphasize the need to relate outcome measures to site-related and treatment-related parameters.