Complications after osteosynthesis of craniofacial fractures-an analysis from the years 2015-2017.

BACKGROUND Complications mean a recurring problem in everyday clinical practice. Complication rates between 6 and 13% are described for the treatment of bony injuries to the head and neck area. This paper aims to provide a detailed analysis of the complications after osteosynthesis in facial skull fractures. MATERIAL AND METHOD In this retrospective study, we reviewed all patient records of injured treated in the Department of Cranial and Maxillofacial Surgery at the Dortmund General Hospital between 2015 and 2017. RESULTS Of the 22,031 head and neck injuries, 685 were treated with osteosynthesis. A clinically significant complication was reported in 32 patients (4.76%). The number of total complications was 63. In total, 66.7% of all complications have been identified in the paramedian mandible (44%), median mandible, mandibular angle, and in the collar area (each 12.7%). Eleven implants (in 5 patients) showed a cancellous bone impaction. Broken implants have been recognized in two cases. In 8 cases, there was a pseudarthrosis in the fracture area; in one case, there was a broken implant and pseudarthrosis in combination. CONCLUSION Osteosynthesis is a safe method of treating facial skull fractures, which is why we consider it the gold standard of therapy. The complication rate is well below 5%. The 3-dimensional adaptation (bending) and shortening of the osteosynthesis implants do not lead to an increase in complications.