The Not Fade Away Phenomenon: 2 Cases of Delayed Nonabsorption of Biodegradable Fixation in Craniosynostosis

Bioresorbable plating systems have been more recently developed as an alternative to metal osteofixation systems and can be used for craniosynostosis operations. To date, the bioresorbable materials used for osteofixation have been used clinically with excellent safety outcomes and good patient outcomes without major plate-induced complications. In this report, we present 2 cases in which bioresorbable materials failed to degrade following operations for craniosynostosis in a chronic manner mandating removal and revision. We also provide a review of the existing literature regarding bioresorbable fixation and evidence of failure to degrade. Based on the clinical courses and pathological findings, it is likely that material factors, combined with the metabolic resorptive capacity and the patient host immune system, contributed to the failure of resorption. Treatment with the removal of implant debris has proven to be effective in other reports, and both patients ultimately progressed with acceptable clinical outcomes. Evaluating rare complications associated with these systems will help provide evidence to inform future product development and refinement. As the field of craniofacial surgery continues to evolve, the use of new materials and technologies promises to enhance patient outcomes, reduce complications, and expand the scope of surgical interventions.