Complications of internal fixation of maxillofacial fractures with microplates

Purpose: The aim of this retrospective study was to evaluate the complicati ons of open reduction and internal fixation of maxillofacial fractures with microplates. Patients and Methods: In 44 patients with maxillofacial trauma, fractures o f the maxillofacial skeleton were treated by open reduction and internal fi xation using a 1.0-mm and 1.5-mm microsystem. Simultaneously occurring frac tures of the mandible or frontozygomatic suture were treated with a 2.0-mm miniplate system. Perioperative and postoperative complications were traced using patient charts, operation reports, and radiographs. The average foll ow-up was 46.8 months (range, 31 to 54 months). Results: A total of 124 1.0-mm microplates and 546 1.0-mm microscrews, and 17 1.5-mm microplates and 75 1.5-mm microscrews, was used. The perioperativ e complication rate was 1.2% for the 1.0-mm screws (use of four emergency s crews, breakage of one screw in the dense frontozygomatic suture area, and an insertion of a screw in a premolar root). The postoperative complication rate was 0.8% for the 1.0-mm screws (screw dislocation without clinical im plication). No complications were observed with the 1.5-mm system. Plate-re lated infection did not occur. All fractures healed well. Three patients as ked for plate removal because of a vague, persisting pain in the treated ar ea. After removal, only one patient was free of pain. A loose 1.5-mm screw was found in this patient. Conclusion: The overall complication rate for microsystems was 2.0%. Both m icrosystems proved to be a reliable modality to fix fractures of the maxill ofacial skeleton. Complications call be considered incidental and of neglec table clinical significance.