Department of Orthopaedic Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Gyeonggi, Korea.
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Seongnam, Gyeonggi, 13620, Korea.
Int Orthop. 2024 Oct;48(10):2681-2687. doi: 10.1007/s00264-024-06284-4. Epub 2024 Aug 26.
This study aimed to compare the surgical outcomes between bioabsorbable and metal screw fixation for distal tibial physeal fracture in children and adolescents, radiographically and clinically.
This study included consecutive 67 children and adolescents who underwent open reduction and internal fixation using metal or bioabsorbable screws for the distal tibia physeal fracture. All patients underwent preoperative radiographs, three-dimensional computed tomography scans, and postoperative follow-up teleradiogram. Patients were divided into metal (N = 40) and bioabsorbable groups (N = 27). We compared the surgical outcomes between the two groups in terms of clinical and radiographic outcomes, length of hospital stays, and medical cost.
Follow-up duration were significantly longer in the metal group than that in the bioabsorbable group. There was no significant difference in the incidence of growth arrest after surgery and the scores of the Oxford Ankle and Foot Questionnaire between the two groups. However, the total hospital stay was significantly longer in the metal group (5.2 ± 4.8 days) compared to the bioabsorbable group (2.6 ± 0.5 days). Medical costs were significantly higher in the bioabsorbable group than in the metal group with a difference of 397 US dollars.
The use of bioabsorbable screws exhibited therapeutic effects equivalent to that of metal screws for pediatric distal tibia physeal fractures regarding clinical and radiological outcomes. Moreover, it had the advantage of avoiding the need for repeated general anesthesia and secondary operation for implant removal. Therefore, the use of bioabsorbable screws may be a favourable surgical option for treating pediatric fractures.
本研究旨在比较儿童和青少年胫骨远端骺板骨折采用可吸收螺钉和金属螺钉固定的手术效果，包括影像学和临床结果。
本研究纳入了 67 名连续就诊的儿童和青少年患者，他们均因胫骨远端骺板骨折行切开复位内固定术，内固定材料分别采用金属螺钉（N=40）和可吸收螺钉（N=27）。所有患者术前均行 X 线、三维 CT 扫描，术后定期行 X 线随访。将患者分为金属组（N=40）和可吸收组（N=27），比较两组患者的手术效果，包括临床和影像学结果、住院时间和医疗费用。
金属组的随访时间明显长于可吸收组。两组患者术后生长停滞的发生率及牛津踝关节和足部评分无显著差异。但金属组的总住院时间（5.2±4.8 天）明显长于可吸收组（2.6±0.5 天），且医疗费用也明显高于可吸收组，差异为 397 美元。
对于儿童胫骨远端骺板骨折，可吸收螺钉与金属螺钉的治疗效果在临床和影像学结果方面相似，且避免了多次全身麻醉和二次手术取内固定的需要。因此，可吸收螺钉可能是治疗儿童骨折的一种有利选择。
