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可生物降解的聚-L-丙交酯-共-乙交酯共聚物针固定治疗一名11岁儿童外伤性髌骨骨软骨碎片:一种新的手术方法。

Biodegradable poly-L-lactide-co-glycolide copolymer pin fixation of a traumatic patellar osteochondral fragment in an 11-year-old child: A novel surgical approach.

作者信息

Sinikumpu Juha-Jaakko, Serlo Willy

机构信息

Department of Pediatric Surgery and Orthopedics, Oulu University Hospital, Oulu, 90029 OYS, Finland.

出版信息

Exp Ther Med. 2017 Jan;13(1):242-246. doi: 10.3892/etm.2016.3934. Epub 2016 Nov 29.

Abstract

Treating displaced patellar bone fractures in growing children remains a challenge for orthopedic surgeons. Removal of loose bone fragments may prolong healing time and result in early onset osteoarthrosis. Therefore, primary fixation of osteochondral fragments is preferred. Metallic pin and screw implants are typically used for fixation, as there is little evidence available regarding the use of modern biodegradable implants in traumatic patellar fractures of a premature skeleton. The present report describes a novel operative technique using headless poly-L-lactide-co-glycolide (PLGA) pins in treating an 11-year-old girl with a patellar fracture from a cycling injury. The surgical technique of this procedure is described in detail in the current report. Excellent subjective outcomes were achieved from this surgery, with superb bone healing according to follow-up radiographic and computerized tomography scans. In conclusion, the results of this case indicate that, similarly to osteochondritis, intra-articular osteochondral fractures in children may be fixed using biodegradable PLGA pins. Randomized clinical trials should be performed to confirm this finding and evaluate the use of PLGA pins as a treatment for adolescent osteochondral fractures.

摘要

对于骨科医生而言,治疗生长发育期儿童的移位性髌骨骨折仍是一项挑战。清除游离骨碎片可能会延长愈合时间并导致早期骨关节炎的发生。因此,首选对骨软骨碎片进行一期固定。金属针和螺钉植入物通常用于固定,因为关于在未成熟骨骼的创伤性髌骨骨折中使用现代可生物降解植入物的证据很少。本报告描述了一种使用无头聚左旋乳酸-共-乙交酯(PLGA)针治疗一名11岁因骑车受伤导致髌骨骨折女孩的新颖手术技术。本报告详细描述了该手术的技术。该手术取得了出色的主观效果,根据随访的X线片和计算机断层扫描显示,骨愈合情况极佳。总之,该病例结果表明,与骨软骨炎类似,儿童关节内骨软骨骨折可用可生物降解的PLGA针进行固定。应进行随机临床试验以证实这一发现,并评估PLGA针作为青少年骨软骨骨折治疗方法的应用。

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