Comparison of surgical outcomes between bioabsorbable and metal screw fixation for distal tibial physeal fracture in children and adolescent.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2024-10-01 Epub Date: 2024-08-26 DOI:10.1007/s00264-024-06284-4

Woo Sub Kim, Min Joon Oh, Moon Seok Park, Ki Hyuk Sung

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Abstract

Purpose: This study aimed to compare the surgical outcomes between bioabsorbable and metal screw fixation for distal tibial physeal fracture in children and adolescents, radiographically and clinically.

Methods: This study included consecutive 67 children and adolescents who underwent open reduction and internal fixation using metal or bioabsorbable screws for the distal tibia physeal fracture. All patients underwent preoperative radiographs, three-dimensional computed tomography scans, and postoperative follow-up teleradiogram. Patients were divided into metal (N = 40) and bioabsorbable groups (N = 27). We compared the surgical outcomes between the two groups in terms of clinical and radiographic outcomes, length of hospital stays, and medical cost.

Results: Follow-up duration were significantly longer in the metal group than that in the bioabsorbable group. There was no significant difference in the incidence of growth arrest after surgery and the scores of the Oxford Ankle and Foot Questionnaire between the two groups. However, the total hospital stay was significantly longer in the metal group (5.2 ± 4.8 days) compared to the bioabsorbable group (2.6 ± 0.5 days). Medical costs were significantly higher in the bioabsorbable group than in the metal group with a difference of 397 US dollars.

Conclusions: The use of bioabsorbable screws exhibited therapeutic effects equivalent to that of metal screws for pediatric distal tibia physeal fractures regarding clinical and radiological outcomes. Moreover, it had the advantage of avoiding the need for repeated general anesthesia and secondary operation for implant removal. Therefore, the use of bioabsorbable screws may be a favourable surgical option for treating pediatric fractures.

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比较生物可吸收和金属螺钉固定治疗儿童和青少年胫骨远端骨骺骨折的手术效果。

目的：本研究旨在比较生物可吸收螺钉和金属螺钉固定治疗儿童和青少年胫骨远端骨骺骨折在影像学和临床方面的手术效果：本研究连续纳入了 67 名使用金属或生物可吸收螺钉进行胫骨远端骨骺骨折切开复位内固定术的儿童和青少年。所有患者均接受了术前X光片、三维计算机断层扫描和术后随访远程X光片检查。患者被分为金属组（40 人）和生物可吸收组（27 人）。我们比较了两组患者在临床和放射学结果、住院时间和医疗费用方面的手术效果：结果：金属组的随访时间明显长于生物可吸收组。两组患者术后生长停滞的发生率和牛津踝足问卷的评分无明显差异。不过，金属组的总住院时间（5.2 ± 4.8 天）明显长于生物可吸收组（2.6 ± 0.5 天）。生物可吸收组的医疗费用明显高于金属组，相差 397 美元：结论：使用生物可吸收螺钉治疗小儿胫骨远端骨骺骨折，在临床和放射学结果方面的疗效与金属螺钉相当。此外，生物可吸收螺钉还具有避免反复全身麻醉和二次手术取出植入物的优点。因此，使用生物可吸收螺钉可能是治疗小儿骨折的有利手术选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.