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通过使用可吸收植入物进行儿童骨合成,无需取出硬件。

Making Hardware Removal Unnecessary by Using Resorbable Implants for Osteosynthesis in Children.

作者信息

Heye Pascal, Matissek Christoph, Seidl Clemens, Varga Marcell, Kassai Tamas, Jozsa Gergö, Krebs Thomas

机构信息

Department of Pediatric Surgery, Pediatric Trauma Surgery, Children's Hospital of Eastern Switzerland, 9000 St. Gallen, Switzerland.

Department of Trauma and Orthopedic Surgery, Landeskrankenhaus Baden-Mödling, 2340 Mödling, Austria.

出版信息

Children (Basel). 2022 Mar 29;9(4):471. doi: 10.3390/children9040471.

Abstract

INTRODUCTION

Following osteosynthesis, children generally require a second surgery to remove the hardware. This becomes unnecessary, by using resorbable implants. Limiting the number of required surgeries and their associated risks, this technique provides critical aspects of minimally invasive surgery. This review focuses on resorbable implants for osteosynthesis for the treatment of fractures in children and discusses their clinical features.

METHOD

We provide an overview of the two most common technologies used in resorbable osteosynthesis materials: polymer- and magnesium-based alloys. Clinical examples of osteosynthesis are presented using polymer-based ActivaTM products and magnesium-based Magnezix products.

RESULTS

Polymer-based implants demonstrate surgical safety and efficacy. Due to their elasticity, initial placement of polymer-based products may demonstrate technical challenges. However, stability is maintained over the course of healing. While maintaining good biocompatibility, the rate of polymer-resorption may be controlled by varying the composition of polyesters and copolymers. Similarly, magnesium-based implants demonstrate good mechanical stability and resorption rates, while these characteristics may be controlled by varying alloy components. One of the significant shortcomings of magnesium is that metabolism results in the production of hydrogen gas. Both technologies provide equally good results clinically and radiographically, when compared to non-resorbable implants.

CONCLUSION

Resorbable osteosynthesis materials demonstrate similar therapeutic results as conventional materials for osteosynthesis. Resorbable implants may have the potential to improve patient outcomes, by sparing children a second surgery for hardware removal.

摘要

引言

在进行骨固定术后,儿童通常需要二次手术来取出内固定物。而使用可吸收植入物则可避免这种情况。该技术减少了所需手术的次数及其相关风险,具备微创手术的关键特性。本综述聚焦于用于儿童骨折治疗的可吸收骨固定植入物,并探讨其临床特点。

方法

我们概述了可吸收骨固定材料中使用的两种最常见技术:聚合物基和镁基合金。使用基于聚合物的ActivaTM产品和基于镁的Magnezix产品展示骨固定的临床实例。

结果

基于聚合物的植入物显示出手术安全性和有效性。由于其弹性,基于聚合物的产品的初始放置可能存在技术挑战。然而,在愈合过程中可保持稳定性。在保持良好生物相容性的同时,聚合物的吸收速率可通过改变聚酯和共聚物的组成来控制。同样,镁基植入物显示出良好的机械稳定性和吸收率,而这些特性可通过改变合金成分来控制。镁的一个显著缺点是代谢会产生氢气。与不可吸收植入物相比,这两种技术在临床和影像学上均能提供同样良好的效果。

结论

可吸收骨固定材料与传统骨固定材料显示出相似的治疗效果。可吸收植入物有可能通过避免儿童进行二次取出内固定物的手术来改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b9f/9031809/eaa612b3ec55/children-09-00471-g001.jpg

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