Resorbable osteosynthetic devices in pediatric traumatology: a prospective series of 24 cases

Autor: J M, Poircuitte, D, Popkov, P, Popkov, H, Huber, D H, Huber, E, Polirsztok, P, Lascombes, P, Journeau
Přispěvatelé: Service d’orthopédie et traumatologie pédiatrique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Federal State-Financed Institution Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Division of Paediatrics Orthopaedic [Geneva], Geneva University Hospital (HUG), Service de Chirurgie d’Orthopédie Pédiatrique [CHRU Nancy]
Rok vydání: 2015
Předmět:
Zdroj: European Journal of Orthopaedic Surgery and Traumatology, Vol. 25, No 6 (2015) pp. 997-1004
European Journal of Orthopaedic Surgery & Traumatology
European Journal of Orthopaedic Surgery & Traumatology, Springer-Verlag, 2015, 25 (6), pp.997-1004. ⟨10.1007/s00590-015-1656-8⟩
ISSN: 1432-1068
1633-8065
0948-4817
DOI: 10.1007/s00590-015-1656-8
Popis: International audience; Bioresorbable devices are commonly used in traumatology. The biomechanical stability of these materials has improved in the past decade, and they have proven to be biologically non-hazardous, while their main advantage is that their use avoids reintervention for removal of the device. A prospective monocentric study was conducted: 24 patients presenting with a fracture that was amenable to osteosynthesis by small-diameter screws were included. These comprised ten tibial spine fractures, four osteochondritis dissecans of the distal femur, eight fractures of the medial epicondyle of the distal humerus, and two distal tibial apophyseal fractures. One or more screws were used that were made of a copolymer of poly-L-lactide-poly-D-lactide acid and trimethylene carbonate with a diameter of 2.8 mm. All patients were immobilized with a cast. Clinical and radiographic monitoring was conducted every month. The entire follow-up protocol had a duration of 24 months. One patient with osteochondritis dissecans presented with joint effusion. Joint stiffness at the time of cast removal resolved completely after 4 months, except for with three children (one epicondyle fracture, two tibial spine fractures). No subjective or objective instability could be detected by clinical examination. Radiographic follow-up revealed no secondary displacement, and all of the fractures had healed. No osteolysis was seen around the screws. No growth disturbances were noticed. Bioresorbable materials thus appear to be a suitable alternative approach for certain pediatric fractures. Their use resulted in outcomes similar to traditional techniques in terms of functional properties and bone healing. Although initial costs are presumably slightly higher, by avoiding a removal operation the total financial burden is most likely reduced.
Databáze: OpenAIRE
Externí odkaz: