Comparison of Titanium versus Resorbable Intramedullary Nailing in Pediatric Forearm Fractures

Area of Science:

• Orthopedics
• Pediatric Surgery
• Biomaterials Science

Background:

• Pediatric diaphyseal forearm fractures are common, often treated with elastic stable intramedullary nailing (ESIN).
• Bioabsorbable poly(lactic-co-glycolic acid) (PLGA) nails present a novel alternative surgical option.

Purpose of the Study:

• To compare the outcomes of using PLGA implants versus titanium elastic nails (TEN) for pediatric diaphyseal forearm fractures.
• To evaluate complication rates, demographic factors, and injury characteristics between the two surgical techniques.

Main Methods:

• Retrospective review of 86 pediatric patients with diaphyseal forearm fractures treated between 2018 and 2022.
• Comparison of outcomes between patients treated with PLGA implants (RESIN technique) and titanium elastic nails (TEN).
• Assessment of patient demographics, injury mechanisms, fracture patterns, and complications.

Main Results:

• Lower complication rates were observed in the PLGA group (7%) compared to the titanium group (20%).
• Patients treated with PLGA implants were younger on average (8.4 years) than those treated with titanium nails (10.4 years).
• Fractures predominantly involved both radius and ulna, with indirect force mechanisms like falls being most common in both groups.

Conclusions:

• Poly(lactic-co-glycolic acid) (PLGA) intramedullary nails are a viable alternative for treating pediatric diaphyseal forearm fractures.
• PLGA implants offer potential advantages including reduced complications, no need for secondary surgery, and cost savings.
• Further prospective randomized trials are recommended to confirm these findings and assess long-term outcomes.