Arch Plast Surg.  2016 Jan;43(1):40-45. 10.5999/aps.2016.43.1.40.

Delayed Foreign Body Reaction Caused by Bioabsorbable Plates Used for Maxillofacial Fractures

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. dhkcool@daum.net

Abstract

BACKGROUND
Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws.
METHODS
A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla.
RESULTS
Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction.
CONCLUSIONS
Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

Keyword

Absorbable implants; Foreign body reaction; Maxillofacial injury

MeSH Terms

Absorbable Implants
Follow-Up Studies
Foreign Bodies*
Foreign-Body Reaction*
Humans
Maxilla
Maxillofacial Injuries
Sutures
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