From the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital.
Plast Reconstr Surg. 2019 Sep;144(3):685-692. doi: 10.1097/PRS.0000000000005932.
The purpose of this study was to investigate surgical outcomes with the use of resorbable plating systems for the repair of craniomaxillofacial trauma in the pediatric population.
A systematic review of the literature was performed. A descriptive analysis, operative technical data, outcomes, and postoperative complications with the use of absorbable plating systems for craniomaxillofacial trauma were included.
The systematic literature review identified 1264 abstracts, of which only 19 met inclusion criteria. From these 19 studies, 312 clinical cases with 443 facial fractures that were treated with absorbable fixation systems were extracted for analysis. The review identified only level III/IV (n = 17) and level V (n = 2) studies. Minor and major complications were rare, occurring in 5.45 percent (n = 17) and 3.21 percent (n = 10) of cases, respectively. The most common complications were surgical-site infections (n = 4) and plate extrusion (n = 4).
This report is, to the authors' knowledge, one of the first comprehensive reports on the use of absorbable plating systems for pediatric craniomaxillofacial trauma. Their analysis suggests that the use of absorbable fixation devices for pediatric craniomaxillofacial trauma is relatively safe, with a low-risk profile. Outcome studies with longer follow-up periods specifically investigating facial growth, reoperation rates, standardized surgical outcome metrics, and cost are necessary to effectively compare these fixation devices to titanium alternatives for craniomaxillofacial trauma.
本研究旨在探讨可吸收接骨板系统在儿童颅颌面创伤修复中的手术效果。
进行了文献系统评价。纳入了使用可吸收接骨板系统治疗颅颌面创伤的描述性分析、手术技术数据、结果和术后并发症。
系统文献检索共识别出 1264 篇摘要,其中仅 19 篇符合纳入标准。这 19 项研究中,有 312 例临床病例,443 例面部骨折采用可吸收固定系统治疗,用于分析。综述仅确定了 3 级/4 级(n = 17)和 5 级(n = 2)研究。轻微和严重并发症罕见,分别占 5.45%(n = 17)和 3.21%(n = 10)。最常见的并发症是手术部位感染(n = 4)和钢板突出(n = 4)。
据作者所知,这是第一篇关于可吸收接骨板系统在儿童颅颌面创伤中应用的综合报告之一。他们的分析表明,可吸收固定装置在儿童颅颌面创伤中的应用相对安全,风险低。需要进行更长随访期的研究,专门研究面部生长、再次手术率、标准化手术结果指标和成本,以便有效地将这些固定装置与钛替代物进行比较,以治疗颅颌面创伤。