THE REMOVAL OF PLATES AND SCREWS AFTER LE-FORT-I OSTEOTOMY

Purpose: This study is a retrospective chart review designed to evalua te the incidence and reasons for removal of plates and screws after Le Fort I osteotomy. Patients and Methods: The study sample consisted of patients who underwent Le Fort I osteotomy at the University of Calif ornia, San Francisco, and Northwestern University in Chicago between D ecember 1985 and December 1994. All patients in the study were treated with internal fixation using 2.0-mm plates and screws. All data were obtained from medical records and operative reports. The following int raoperative variables were evaluated: hardware material, plate size an d shape, plate location, screw size, graft material, and intraoperativ e complications. For patients requiring removal of hardware, the numbe r, location and type of plates and screws removed were recorded, as we ll as the reasons for removal. Results: A total of 738 plates were pla ced in 190 patients. Twenty-one of the 190 patients (11.1%) had at lea st a portion of the hardware removed because they either requested rem oval or required removal secondary to complications related to the pla te or screw. This represented 70 of 738 plates (9.5%). The percentage of titanium plates removed was greater than the percentage of Vitalliu m plates removed. The reasons for removal included pain, palpation by the patient, sinusitis, temperature sensitivity, infection, and patien t request. Conclusion: Only a small number of patients (10.6%) develop complications from plates or screws that required their removal. In e ach case, prompt removal constituted adequate management.