Baldini Marco, Coppa Valentino, Falcioni Danya, Senigagliesi Elisa, Marinelli Mario, Gigante Antonio Pompilio
Clinical Orthopedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Ancona, Italy.
Clinic of Adult and Paediatric Orthopedic, Azienda Ospedal-iero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy.
J Child Orthop. 2021 Jun 1;15(3):194-203. doi: 10.1302/1863-2548.15.210004.
Biodegradable implants are of major interest in orthopaedics, especially in the skeletally immature population. Magnesium (Mg) implants are promising for selected surgical procedure in adults, but evidence is lacking. Thus, the aim of this study is to analyze the safety and efficacy of resorbable Mg screw in different orthopaedic procedures in skeletally immature patients. In addition, we present a systematic review of the current literature on the clinical use of Mg implants.
From 2018 until the writing of this manuscript, consecutive orthopaedic surgical procedures involving the use of Mg screws performed at our centre in patients < 15 years of age were retrospectively reviewed. In addition, a systematic review of the literature was performed in the main databases. We included clinical studies conducted on humans, using Mg-alloy implants for orthopaedic procedures.
A total of 14 patients were included in this retrospective analysis. Mean age at surgery was 10.8 years (sd 2.4), mean follow-up was 13.8 months (sd 7.5). Healing was achieved in all the procedures, with no implant-related adverse reaction. No patients required any second surgical procedure. The systematic review evidenced 20 clinical studies, 19 of which conducted on an adult and one including paediatric patients.
Evidence on resorbable Mg implants is low but promising in adults and nearly absent in children. Our series included apophyseal avulsion, epiphyseal fractures, osteochondritis dissecans, displaced osteochondral fragment and tendon-to-bone fixation. Mg screws guaranteed stable fixation, without implant failure, with good clinical and radiological results and no adverse events.
IV - Single cohort retrospective analysis with systematic review.
可生物降解植入物在骨科领域备受关注，尤其是在骨骼未成熟人群中。镁（Mg）植入物在成人特定手术中具有应用前景，但相关证据不足。因此，本研究旨在分析可吸收镁螺钉在骨骼未成熟患者不同骨科手术中的安全性和有效性。此外，我们还对当前关于镁植入物临床应用的文献进行了系统综述。
回顾性分析2018年至撰写本文期间，在我们中心为年龄小于15岁的患者进行的涉及使用镁螺钉的连续骨科手术。此外，在主要数据库中对文献进行了系统综述。我们纳入了对人类进行的临床研究，这些研究使用镁合金植入物进行骨科手术。
本回顾性分析共纳入14例患者。手术时的平均年龄为10.8岁（标准差2.4），平均随访时间为13.8个月（标准差7.5）。所有手术均实现愈合，未出现与植入物相关的不良反应。没有患者需要进行任何二次手术。系统综述发现了20项临床研究，其中19项针对成人，1项包括儿科患者。
关于可吸收镁植入物的证据较少，但在成人中具有应用前景，而在儿童中几乎没有相关证据。我们的系列病例包括骨骺撕脱、骨骺骨折、剥脱性骨软骨炎、移位的骨软骨碎片和肌腱-骨固定。镁螺钉保证了稳定的固定，没有植入物失败，临床和影像学结果良好，且无不良事件。
IV - 单队列回顾性分析并进行系统综述。
