Yasonov S A, Lopatin A V, Bel'chenko V A, Vasil'ev I G
Russian Children's Clinical Hospital, Moscow, Russia, 119571, Pirogov Russian National Research Medical University, Moscow, Russia, 117997.
Russian Children's Clinical Hospital, Moscow, Russia, 119571.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(6):48-55. doi: 10.17116/neiro201781648-55.
Over the past 15 years, resorbable materials have been successfully used for osteosynthesis, but their high cost prevents widespread application. However, the use of resorbable systems could be a method of choice, especially in treatment of children in the active growth period. Obviously, biodegradable materials not only are highly competitive with known metal constructs in terms of fixation rigidity, biocompatibility, and a low risk of infection but also have an undeniable advantage, such as gradual resorption allowing quick return of damaged bones to the physiological conditions of functioning. A special feature of bioresorbable systems is that they can be assembled using ultrasonic welding, which greatly facilitates the fixation process and also provides necessary rigidity, even in cases of joining very thin bones when reliable fixation with screws is impossible.
Over the past 10 years, we have used biodegradable systems in 324 patients. In 244 of them, we used traditional (plate/screw) systems; in 80 cases, an ultrasonic welding system was chosen for osteosynthesis.
In the present work, we discuss, based on clinical evidence, the advantages and disadvantages of both fixation systems for reconstructive craniofacial surgery in children.
在过去15年里,可吸收材料已成功用于骨固定,但因其成本高昂,阻碍了其广泛应用。然而,使用可吸收系统可能是一种优选方法,尤其在治疗处于生长活跃期的儿童时。显然,生物可降解材料不仅在固定刚度、生物相容性和低感染风险方面与已知金属结构具有高度竞争力,而且具有不可否认的优势,例如逐渐吸收可使受损骨骼迅速恢复到生理功能状态。生物可吸收系统的一个特殊之处在于它们可以通过超声波焊接进行组装,这极大地简化了固定过程,并且即使在连接非常薄的骨骼且无法用螺钉可靠固定的情况下,也能提供必要的刚度。
在过去10年里,我们在324例患者中使用了生物可降解系统。其中244例使用了传统(钢板/螺钉)系统;80例选择了超声波焊接系统进行骨固定。
在本研究中,我们基于临床证据讨论了这两种固定系统在儿童重建颅面外科手术中的优缺点。