Is biodegradable pin a good choice for lateral condylar fracture of humerus in children

Li, Jin; Rai, Saroj; Liu, Yudong; Ze, Renhao; Tang, Xin; Liu, Ruikang; Hong, Pan

doi:10.1097/md.0000000000021696

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…While hospitalization time was similar, operating time was significantly higher in the rOSM group compared to TEN (mean 80 min vs. mean 53 min, p = 0.014). Equally satisfying results were demonstrated using polymer-based implants for the treatment of radial condyle [43], medial epicondyle [44], supracondylar humerus [45], and patellar fractures [46].…”

Section: Stabilitymentioning

confidence: 98%

Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children

Heye¹,

Matissek²,

Seidl

et al. 2022

Children

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Introduction: Following osteosynthesis, children generally require a second surgery to remove the hardware. This becomes unnecessary, by using resorbable implants. Limiting the number of required surgeries and their associated risks, this technique provides critical aspects of minimally invasive surgery. This review focuses on resorbable implants for osteosynthesis for the treatment of fractures in children and discusses their clinical features. Method: We provide an overview of the two most common technologies used in resorbable osteosynthesis materials: polymer- and magnesium-based alloys. Clinical examples of osteosynthesis are presented using polymer-based ActivaTM products and magnesium-based Magnezix® products. Results: Polymer-based implants demonstrate surgical safety and efficacy. Due to their elasticity, initial placement of polymer-based products may demonstrate technical challenges. However, stability is maintained over the course of healing. While maintaining good biocompatibility, the rate of polymer-resorption may be controlled by varying the composition of polyesters and copolymers. Similarly, magnesium-based implants demonstrate good mechanical stability and resorption rates, while these characteristics may be controlled by varying alloy components. One of the significant shortcomings of magnesium is that metabolism results in the production of hydrogen gas. Both technologies provide equally good results clinically and radiographically, when compared to non-resorbable implants. Conclusion: Resorbable osteosynthesis materials demonstrate similar therapeutic results as conventional materials for osteosynthesis. Resorbable implants may have the potential to improve patient outcomes, by sparing children a second surgery for hardware removal.

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Section: Stabilitymentioning

confidence: 98%

Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children

Heye¹,

Matissek²,

Seidl

et al. 2022

Children

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Kirschner wire vs screw osteosynthesis of lateral condyle fractures in paediatric patients: a systematic review

Mostofi Zadeh Haghighi,

Xu,

Campbell

et al. 2024

Musculoskelet Surg

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This systematic review compares Kirschner wires versus a single cannulated screw for the treatment of lateral humeral condyle fractures in children. The purpose of this review is to review the current literature on fixation of lateral condyle fractures of the humerus, and to ascertain whether there is a difference in clinical outcomes of these fractures when fixated with K-wires vs screws. This systematic review of the literature comparing surgical management of paediatric (0–17 years of age) lateral condyle fractures with K-wire versus screw fixation was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic searches of three databases from inception to March 2022 yielded 17 studies which satisfied inclusion criteria, comprising 1,272 patients with a median age of 8.5 years. Eight hundred and fifty-five (67.2%) patients underwent K-wire fixation and 417 (32.8%) underwent screw fixation. Results were divided into comparative and single-arm studies. The median follow-up time was 23.3 months (range 3 months–22 years). A lateral prominence was observed in 114 (13.3%) patients with K-wires and 41 (9.8%) patients with a cannulated screw. An infection developed in 52 (6.1%) patients with K-wires, while only five (1.2%) patients with a screw developed an infection. A carrying angle deformity occurred in 61 (7.1%) patients with K-wires and seven (1.7%) patients with a screw. K-wires and cannulated screws are effective and safe methods of fixation for lateral humeral condyle fractures in children. K-wire fixation may have a greater incidence of infection but allows for safe non-operative removal and versatility with fractures of greater comminution, while screw fixation necessitates a second operation for removal following union.Level of Evidence III Systematic review.

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Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire

Rai

Gao

et al. 2020

BMC Musculoskelet Disord

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Background The clinical outcome of open reduction and internal fixation (ORIF) for delayed lateral condylar fracture of the humerus (LCFH) varies in different studies, but ORIF for LCFH with an early-delayed presentation usually resulted in significant improvement of elbow function. Early delayed presentation is defined as a period of 3 to 12 weeks from the injury. This study aims to compare the clinical outcomes of biodegradable pin (BP) vs. Kirschner wire (KW) in the treatment of LCFH with an early delayed presentation. Methods LCFH with an early-delayed presentation treated with KW or BP were retrospectively reviewed in our hospital. The patients were divided into two groups KW (n = 17) and BP group (n = 26). Baseline information, including sex, age, operative side, duration from injury to surgery, and implant choice, was reviewed. Radiographs and medical records were collected from the Hospital Database. Results In all, 17 patients (male/female, 9/8) in KW and 26 patients (male/female,13/13) in the BP group were included. The age showed no statistically significant difference between the KW (52.3 ± 10.2, month) and the BP (56.1 ± 10.7, month), (P = 0.258). At the last follow-up, there existed no statistically significant difference between the two groups concerning Baumann’s angle (P = 0.272) and carrying angle (P = 0.911). The MEPS at the last follow-up was better in the KW group (91.1 ± 2.7) than the BP group (89.2 ± 3.0), (P = 0.048). There was no case of nonunion or malunion in both groups. The incidence of fishtail deformity was (8/17, 47.1%) in KW and (13/26, 50%) in the BP group. The incidence of lateral prominence was (5/17, 29.4%) in the KW and (7/26, 26.9%) in the BP group. Furthermore, the incidence of implant prominence was higher in KW (12/17, 70.6%) than BP (0) (P < 0.001). Conclusion Open reduction and internal fixation for LCFH with an early-delayed presentation produced satisfactory outcomes. Biodegradable pin is a good alternative to Kirschner wire, with comparable clinical outcomes.

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Is biodegradable pin a good choice for lateral condylar fracture of humerus in children

Cited by 4 publications

References 33 publications

Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children

Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children

Kirschner wire vs screw osteosynthesis of lateral condyle fractures in paediatric patients: a systematic review

Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire

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