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Delayed degradation in a resorbable plating system
Richard Mackool1, Jun Yim, Joseph G McCarthy
1Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY, USA.
The Journal of Craniofacial Surgery
|January 25, 2006
Summary
Resorbable plates for craniofacial reconstruction can cause complications. Four pediatric patients required surgical removal of these plates due to palpable hardware and bone irregularities after 2 years.
Area of Science:
- Craniofacial surgery
- Biomaterials science
- Pediatric orthopedics
Background:
- Resorbable plating systems offer advantages over permanent plates for craniofacial reconstruction, especially in children.
- Potential benefits include reduced risks of plate migration, bone growth restriction, and imaging artifacts.
- However, the resorption process itself presents unique challenges.
Observation:
- Four pediatric patients developed palpable and observable resorbable plates for over two years post-craniofacial remodeling.
- All patients eventually required surgical removal of the plates.
- Gross examination revealed encapsulated spongy material and underlying bone depression with irregular contours.
Findings:
- Histopathological analysis showed a foreign-body reaction with giant cells and crystalline material within vacuoles.
- The resorbable plates did not fully resorb as intended within the observed timeframe.
- Significant inflammatory and tissue response was noted around the persistent plate material.
Implications:
- These findings suggest potential complications associated with resorbable plating systems in pediatric craniofacial reconstruction.
- Further research is needed to understand the mechanisms of delayed resorption and associated inflammatory responses.
- Clinical vigilance and consideration of alternative fixation methods may be warranted in specific pediatric cases.