Resorbable plate fixation in pediatric craniofacial surgery: long-term outcome
M J Imola1, D D Hamlar, W Shao
1Center for Craniofacial-Skull Base Surgery, 1601 E 19th Ave, Suite 3100, Denver, CO 80218, USA. mjimola@qwest.net
Insights
Resorbable plate fixation shows high efficacy in pediatric craniofacial surgery, with excellent bone healing and minimal complications. This advanced technique offers a safe alternative to traditional metal fixation for young patients.
Area of Science:
- Pediatric Craniofacial Surgery
- Biomaterials in Orthopedics
- Surgical Fixation Devices
Background:
- Traditional metal fixation in pediatric craniofacial surgery poses risks like hardware complications.
- Resorbable implants offer a potential alternative to overcome these limitations.
Purpose of the Study:
- To evaluate the long-term effectiveness of resorbable plate fixation in pediatric craniofacial surgery.
- To compare outcomes with traditional metal fixation methods.
Main Methods:
- A retrospective review of 57 pediatric craniofacial fixation cases using resorbable plates and screws.
- Analysis of bone healing (union, malunion, nonunion) and complications (extrusion, infection).
Main Results:
- 96% anatomical union and uncomplicated healing in midfacial/upper face procedures (54 patients).
- Low complication rate (3.7% plate extrusion), managed conservatively.
- Comparable outcomes and costs to metal osteosynthesis.
Conclusions:
- Bioresorbable plate fixation is effective and safe for pediatric craniofacial surgery.
- Recommended for low-stress, non-load-bearing areas, offering an advantage over metal implants.
- Represents a significant advancement despite an initial learning curve.
Objective:
To determine the long-term efficacy of resorbable plate fixation in pediatric patients undergoing craniofacial surgery for congenital anomalies, traumatic deformities, or skull base tumors.
Design:
Retrospective case review.
Materials And Methods:
Medical records of 57 consecutive cases using resorbable plates and screws for craniofacial fixation in patients younger than 18 years were analyzed.
Main Outcome Measures:
The status of bone healing postoperatively (anatomical union, malunion, delayed union, or nonunion) and any complications or adverse effects (hardware visibility or palpability, plate extrusion, or infection) were noted.
Results:
In midfacial and upper face procedures (54 patients) anatomical union and uncomplicated bone healing occurred in 52 (96%) of the patients. In this same group, complications (plate extrusion) occurred in 2 patients (3.7%) and were resolved using conservative treatment without untoward sequelae. These outcomes are comparable to results using metal osteosynthesis in similar situations. Costs of resorbable hardware are similar to existing metal fixation systems.
Conclusions:
Our data support the use of bioresorbable plate fixation in pediatric craniofacial surgery as a means of avoiding the potential and well-documented problems with rigid metal fixation. Indications include fractures and segmental repositioning in low-stress non-load-bearing areas of the middle and upper craniofacial skeleton. Although there is an initial learning curve in using this technology, we believe the benefits are well worth the effort and represent a major advance in pediatric craniofacial surgery.
