{"title":"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。","authors":"Florence Eastwood, Firas Raheman, Ghaith Al-Dairy, Maria Popescu, Clare Henney, Liz Hunwick, Pranai Buddhdev","doi":"10.1177/18632521251350854","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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°, <i>p</i> = 0.030) and elbow flexion (153.8° versus 144.8°, <i>p</i> = 0.001) for bioabsorbable intramedullary nails. Pain scores were comparable, with fewer bioabsorbable intramedullary nail patients reporting postoperative pain.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"422-431"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364838/pdf/","citationCount":"0","resultStr":"{\"title\":\"Healing smarter: A systematic review and meta-analysis of bioresorbable implants for paediatric forearm fractures.\",\"authors\":\"Florence Eastwood, Firas Raheman, Ghaith Al-Dairy, Maria Popescu, Clare Henney, Liz Hunwick, Pranai Buddhdev\",\"doi\":\"10.1177/18632521251350854\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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°, <i>p</i> = 0.030) and elbow flexion (153.8° versus 144.8°, <i>p</i> = 0.001) for bioabsorbable intramedullary nails. Pain scores were comparable, with fewer bioabsorbable intramedullary nail patients reporting postoperative pain.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":56060,\"journal\":{\"name\":\"Journal of Childrens Orthopaedics\",\"volume\":\" \",\"pages\":\"422-431\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364838/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Childrens Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/18632521251350854\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Childrens Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/18632521251350854","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Healing smarter: A systematic review and meta-analysis of bioresorbable implants for paediatric forearm fractures.
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.
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.
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