The removal of plates and screws after Le Fort I osteotomy

Purpose: This study is a retrospective chart review designed to evaluate 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 California, San Francisco, and Northwestern University in Chicago between December 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 intraoperative variables were evaluated: hardware material, plate size and shape, plate location, screw size, graft material, and intraoperative complications. For patients requiring removal of hardware, the number location and type of plates and screws removed were recorded, as well as the reasons for removal. Results: A total of 738 plates were placed in 190 patients. Twenty-one of the 190 patients (11.1%) had at least a portion of the hardware removed because they either requested removal or required removal secondary to complications related to the plate or screw. This represented 70 of 738 plates (9.5%). The percentage of titanium plates removed was greater than the percentage of Vitallium plates removed. The reasons for removal included pain, palpation by the patient, sinusitis, temperature sensitivity, infection, and patient request. Conclusion: Only a small number of patients (10.6%) develop complications from plates or screws that required their removal. In each case, prompt removal constituted adequate management.