Risk Factors for Plate Extrusion Following Mandibular Recons
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Plate extrusion following mandibular reconstruction is a complication that imposes significant morbidity upon the patient. This study reports that history of smoking, number of osteotomies, and non-viability of the flaps are linked with plate extrusion in mandible reconstruction.

The goal of this study published by the Journal of Oral and Maxillofacial Surgery is to estimate the incidence of plate extrusion following mandible reconstruction with a vascularized free flap and to identify the factors associated with plate extrusion.

This was a retrospective cohort study involving patients who underwent mandibular reconstruction. Inclusion criteria were age ? 18, single-stage mandibular reconstruction with vascularized free flap, and follow-up of at least 12 months. Relevant demographic, intraoperative, and postoperative data were collected. The primary outcome was postoperative plate extrusion within the 12 months follow-up.

102 patients were included in this study. The majority received a fibula-free flap for a malignant neoplasm.

The study result was;
--The rate of plate extrusion was 16%, with the majority of those patients undergoing plate removal.

--After adjusting for post-operative fistula, soft tissue, and length of hospitalization, investigators found that any history of smoking, number of osteotomies, flap non-viability were associated with plate extrusion on multivariate analysis.

--Post-operative soft tissue infection approached significance.

Source: https://doi.org/10.1016/j.joms.2021.02.009
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