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[Preliminary results of biodegradable osteosynthesis in craniofacial surgery in the child]
O E Illi1, H Sailer, U G Stauffer
1Service de Chirurgie, Hôpital universitaire, Zürich, Suisse.
Insights
Biodegradable polylactate acid implants effectively fix cranial defects in pediatric patients. These implants offer good aesthetic and clinical results, with full resorption observed on CT scans.
Area of Science:
- Craniofacial Surgery
- Biomaterials Science
- Pediatric Neurosurgery
Background:
- Biodegradable implants offer potential advantages over traditional materials for craniofacial reconstruction.
- Previous experimental studies in minipigs demonstrated the efficacy of polylactate acid implants.
Purpose of the Study:
- To evaluate the clinical safety and efficacy of biodegradable polylactate acid implants in pediatric craniofacial reconstructive surgery.
- To compare the outcomes of biodegradable implants with conventional fixation methods.
Main Methods:
- A clinical trial involving 8 pediatric patients (aged 1-18 years) with various craniofacial deformities and defects.
- Application of polylactate acid implants for fixation in skull plasties, frontal advancements, and skull splitting procedures.
- Clinical, radiological (CT scans), and aesthetic assessments during a follow-up period of 2-20 months.
Main Results:
- Successful fixation achieved in all 8 patients using biodegradable polylactate acid implants.
- Good aesthetic and clinical outcomes comparable to conventional materials like wire loops.
- Complete resorption of implants confirmed by CT scans, with no need for removal.
- Demonstrated successful use in complex procedures including frontal advancement and skull splitting.
Conclusions:
- Biodegradable polylactate acid implants are a safe and effective alternative for pediatric craniofacial reconstruction.
- These implants provide comparable aesthetic and functional results to traditional fixation methods.
- The complete resorption of polylactate acid implants eliminates the need for secondary removal surgeries.
Abstract:
After an experimental study on biodegradable implants for fixation purpose in skull plasties of the minipig we began a clinical trial. Six children aged 1-18 years and suffering from trigonocephaly, Morbus Apert and Morbus Crouzon as well as plagiocephaly underwent a reconstructive procedure of the skull and midface, mostly frontal advancement. The different part of skull have been fixed by biodegradable implants made of polylactate acid. Another two infants, one with a skull defect after removal of an encephalocele and the other for reconstruction of the skull after open cerebral injury and consecutive osteoclastic trepanation, have been treated with skull splitting. The two halves of the skull have been fixed by biodegradable material too. The follow-up of these 8 children now is from 2-20 months (medium 10 1/2 months). From the aesthetic point of view as well as from radiological and clinical signs we judge the result as good as with conventional materials, for example wire loops. No material had to be removed and CT scans show a fully resorption of the implants. The present paper shows the preoperative, intraoperative and postoperative evolution.