Fate of Implanted Maxillofacial Plates and Screws after Facial Fractures: A 10-Year Review

Abstract Background: Contemporary maxillofacial osteosynthesis has become the standard of care in Nigeria. Grey literature exists on the fate of implanted hardware in the world’s most populous Black nation. Therefore, this study aimed to determine the rate and indications for hardware removal following open reduction and internal fixation (ORIF) of facial fractures. Materials and Methods: A 10-year (2013–2022) retrospective review of patients’ charts at a tertiary hospital in Nigeria was undertaken. Demographics, location and duration of implants in situ and indications for removal were retrieved and entered into a Microsoft Excel spreadsheet. Results: One hundred and nine patients of 381 patients who sustained facial fractures during the study period underwent ORIF using titanium implants. Osteosynthesis hardware were removed in three patients (2.8%), all of who were males. Indications for removal include plate migration and infection ( n = 1) and asymptomatic removal ( n = 2; patient’s request and growth concern in a child). Overall, nine plates and 38 screws were removed. These comprised seven plates and 30 screws removed from the mandible and two plates and eight screws retrieved from the maxilla. Mandibles accounted for 77.8% of the implanted hardware that were removed. Titanium implants were removed within the fifth month (plate migration and infection), sixth month (growth concern) and 2 years of placement (patient’s request). Conclusions: Hardware removal rate in our centre is lower than the previously reported rates elsewhere. Indications for removal were plate migration and infection, prophylactic removal in paediatric patients and patient’s wish.