Healing smarter: A systematic review and meta-analysis of bioresorbable implants for paediatric forearm fractures.

IF 1.6 4区医学 Q3 ORTHOPEDICS

Journal of Childrens Orthopaedics Pub Date : 2025-08-19 eCollection Date: 2025-10-01 DOI:10.1177/18632521251350854

Florence Eastwood, Firas Raheman, Ghaith Al-Dairy, Maria Popescu, Clare Henney, Liz Hunwick, Pranai Buddhdev

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引用次数: 0

Abstract

Purpose: Paediatric forearm fractures are among the most common childhood injuries, with diaphyseal fractures often requiring surgical management due to their instability and poorer remodelling potential. Traditional methods, such as elastic stable intramedullary nailing, are effective but require secondary procedures for implant removal, increasing healthcare burdens. Bioabsorbable intramedullary nails offer an alternative, eliminating the need for implant removal. This systematic review and meta-analysis evaluates the efficacy and safety of bioabsorbable intramedullary nails compared to conventional methods.

Methods: Five studies, including 255 paediatric patients with 399 forearm fractures, were included. Of these, 159 were treated with bioabsorbable intramedullary nails. Meta-analyses assessed outcomes, including fracture healing time, complications, functional results and reoperation rates.

Results: Bioabsorbable intramedullary nails demonstrated fracture healing times comparable to elastic stable intramedullary nailing (10.67 weeks; 95% CI: 8.92-11.42) with no significant differences. Complication rates were similar, with nine re-fractures in the bioabsorbable intramedullary nail group and 10 in the elastic stable intramedullary nailing group. Secondary displacement occurred in 3.1% of bioabsorbable intramedullary nail patients versus 4.7% for elastic stable intramedullary nailing. Functional outcomes showed improved pronation (78.5° versus 72.7°, p = 0.030) and elbow flexion (153.8° versus 144.8°, p = 0.001) for bioabsorbable intramedullary nails. Pain scores were comparable, with fewer bioabsorbable intramedullary nail patients reporting postoperative pain.

Conclusions: Bioabsorbable intramedullary nails are a safe and effective alternative to elastic stable intramedullary nailing, offering equivalent clinical outcomes while eliminating the need for implant removal. Larger, long-term studies are needed to confirm these findings and evaluate the cost-effectiveness of bioabsorbable intramedullary nails in paediatric fracture management.

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更聪明的愈合：对儿童前臂骨折生物可吸收植入物的系统回顾和荟萃分析。

目的：儿童前臂骨折是最常见的儿童损伤之一，骨干骨折由于其不稳定和较差的重建潜力，通常需要手术治疗。传统的方法，如弹性稳定髓内钉，是有效的，但需要二次手术来移除植入物，增加了医疗负担。生物可吸收髓内钉提供了另一种选择，消除了移除植入物的需要。本系统综述和荟萃分析评估了生物可吸收髓内钉与传统方法相比的有效性和安全性。方法：纳入5项研究，包括255例小儿前臂骨折399例。其中159例采用生物可吸收髓内钉治疗。meta分析评估了结果，包括骨折愈合时间、并发症、功能结果和再手术率。结果：生物可吸收髓内钉骨折愈合时间与弹性稳定髓内钉相当（10.67周；95% CI: 8.92-11.42），差异无统计学意义。并发症发生率相似，生物可吸收髓内钉组9例再骨折，弹性稳定髓内钉组10例再骨折。生物可吸收髓内钉患者继发移位发生率为3.1%，而弹性稳定髓内钉患者继发移位发生率为4.7%。功能结果显示生物可吸收髓内钉可改善旋前（78.5°对72.7°，p = 0.030）和肘关节屈曲（153.8°对144.8°，p = 0.001）。疼痛评分具有可比性，较少的生物可吸收髓内钉患者报告术后疼痛。结论：生物可吸收髓内钉是一种安全有效的替代弹性稳定髓内钉的方法，其临床效果与弹性稳定髓内钉相当，且无需移除植入物。需要更大规模的长期研究来证实这些发现，并评估生物可吸收髓内钉在小儿骨折治疗中的成本效益。

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

Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine

CiteScore

2.70

自引率

14.30%

发文量

审稿时长

23 weeks

期刊介绍： Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.