Osteosynthesis plate removal: Patient benefits and burdens

Maxillofacial fractures are lege artis treated via open reduction and internal fixation in cases of dislocation of the fracture. Plate removal is indicated for various reasons. Whereas symptomatic plate removals are justified, elective removals are questionable. This retrospective monocenter study examined the individual benefit of plate removal from the patient's point of view and involved 233 patients undergoing plate removal. The data of 233 patients undergoing plate removal were first collected, and then, an individual follow-up questionnaire was created that assessed the personal reasons of patients requesting removal and addressed whether the patient gained any benefit from removal surgery. A total of 43 patients agreed to complete the survey. The complication rate was lower after plate removal (13.3%) than after osteosynthesis (31.8%). The most common indication for removal was surgeon recommendation (51.9%), followed by ongoing symptoms (31.3%) and request by the patient (16.7%). Significantly, more patients underwent symptomatic plate removal after mandibular fractures (46.8%, n = 37, p = 0.001) than fractures elsewhere. According to the survey, 86% (n = 37) of the patients benefitted from plate removal. Although elective plate removal is nowadays controversial, our data provide evidence for a high level of patient satisfaction after removal surgery.