Evaluation of determinants affecting the explanation of titanium osteosynthesis plates in maxillofacial trauma management.

Objective: To evaluate determinants affecting the explanation of titanium osteosynthetic plates in maxillofacial trauma management. Study Design: Cross-sectional. Setting: Lady Reading Hospital, Peshawar, Pakistan. Period: January 2018 to December 2022. Methods: The study included 250 patients with maxillofacial fractures who underwent treatment with titanium plate fixation. The patients’ demographic, clinical, and surgical variables were analysed using SPSS. Results: Plate removal occurred in 20% of cases (50 plates out of 250). The most common causes were: an infection (18 out of 50, 36.4%); persistent pain (14 out of 50, 28%); and request of the patients themselves (14 out of 50, 28%). Assault related injuries constituted a striking 42% (21 out of 50) of removals (p=0.003) while the association of miniplate use with 64% (32 out of 50) of the explantations is statistically significant (p=0.01). The use of titanium alloy plates had significantly lower removal rates (16 out of 50, 32%) compared to pure titanium (p=0.02). Conclusion: The risk of infection, the type of plate used, and the mechanism of trauma all significantly impact explantation rates. These results substantiate multi-level bespoke strategy formulation with a focus on high-risk scenarios that use miniplates or those resulting from assaults.