Section of Plastic Surgery, University of Michigan, Ann Arbor, MI.
J Craniofac Surg. 2024 Jun 1;35(4):1052-1056. doi: 10.1097/SCS.0000000000010032. Epub 2024 Feb 13.
The hardware utilized for rigid internal fixation of the craniofacial skeleton has evolved over time. Thus, the reasons for the unplanned removal of hardware continue to change. The purpose of this study is to compare past (1989-1995) and present (2000-2020) patient cohorts to establish trends related to unplanned removal of craniofacial hardware. A retrospective review study was designed. Data from our institution's original publication describing the unplanned removal of craniofacial hardware (1989-1995) was obtained. Data related to patients who underwent unplanned removal of hardware from 2000 to 2020 was collected from the electronic medical record. A descriptive statistical analysis was performed to compare demographics, reasons for hardware placement, and reasons for unplanned hardware removal between cohorts. This study includes 55 patients treated from 1989 to 1995 and 184 patients treated from 2000 to 2020. The average age at hardware placement decreased from 32 years (1989-1995) to 28 years (2000-2020). The most common reason for hardware placement changed from motor vehicle accident (1989-1995) to congenital deformity (2000-2020). The length of time with hardware in situ increased from 13 months (1989-1995) to 25 months (2000-2020). The most common reason for hardware removal changed from prominent hardware (1989-1995) to hardware exposure (2000-2020). In summary, patients who underwent rigid internal fixation of the craniofacial skeleton from 2000 to 2020 retained their hardware 2 times longer than patients treated from 1989 to 1995. Factors potentially contributing to increased retention include improved surgical technique, decreased profile of hardware, and increased surgeon experience. Further studies are warranted to define preoperative risk factors for unplanned hardware removal.
颅面骨骼的刚性内固定所使用的硬件随着时间的推移而发展。因此，计划外移除硬件的原因仍在不断变化。本研究的目的是比较过去（1989-1995 年）和现在（2000-2020 年）的患者队列，以确定与颅面硬件计划外移除相关的趋势。本研究设计为回顾性研究。从我院原始出版物中获取了描述颅面硬件计划外移除的相关数据（1989-1995 年）。从电子病历中收集了 2000 年至 2020 年期间因计划外移除硬件而接受治疗的患者的数据。对两组患者的人口统计学数据、硬件放置原因和计划外硬件移除原因进行描述性统计分析。本研究共纳入 1989 年至 1995 年治疗的 55 例患者和 2000 年至 2020 年治疗的 184 例患者。硬件放置的平均年龄从 32 岁（1989-1995 年）降至 28 岁（2000-2020 年）。硬件放置的最常见原因从机动车事故（1989-1995 年）变为先天性畸形（2000-2020 年）。硬件在位时间从 13 个月（1989-1995 年）延长至 25 个月（2000-2020 年）。硬件移除的最常见原因从突出的硬件（1989-1995 年）变为硬件暴露（2000-2020 年）。总之，2000 年至 2020 年接受颅面骨骼刚性内固定治疗的患者比 1989 年至 1995 年接受治疗的患者保留硬件的时间长 2 倍。导致保留时间增加的因素可能包括手术技术的提高、硬件轮廓的减小和外科医生经验的增加。进一步的研究是必要的，以确定计划外硬件移除的术前危险因素。
