Гений oртопедии (Dec 2023)
Resorbable implants in paediatric orthopaedics and traumatology
Abstract
Background Development of resorbable implants for paediatric orthopaedics is promising as there is no need for implant removal. The aim of this paper is to present our experience in resorbable implants in paediatric traumatology, and to make an overview of the recent literature. Material and methods In our department of paediatric traumatology and orthopaedics, we have operated 7 children with fractures of long bones with resorbable screws (ActivaScrew™). The inclusion criteria were intra-articular and juxta-articular fractures in children with an indication for screw fixation. To prepare the review, we searched for information sources at the scientific platforms such as PubMed, Scopus, ResearchGate, RSCI, as well as other published products (Elsevier, Springer). Results The cohort is represented by 7 patients, 4 girls and 3 boys, aged from 5 to 14 years old. The 7 fractures were 3 at the elbow and 4 at the ankle joint. In the immediate postoperative period, no patient presented with abnormal swelling, redness, or tissue reaction. Pain disappeared at day 7 in all cases. Weight-bearing and return to sport activities were allowed in normal delay. Radiological bone union was obtained between 3 and 6 weeks. Range of motion in adjacent joints was comparable to the opposite non-fractured side at 3 months. There were no cases of complications, no infection, and no need for a reoperation. Discussion The use of resorbable implants, either co-polymers or magnesium, solves the problem: removal of implants is not anymore necessary. Resorbable implants are becoming safer as they have good solidity allowing bone union of fractures and osteotomies before their eliminating. Conclusion Main indications of resorbable implants in pediatrics remain fractures and osteotomies fixed with screws. The development of plates and intramedullary nails will enlarge the indications. Level of evidence: IV.
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