Use of biodegradable plates and screws in the treatment of pediatric facial bone fractures

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Abstract

Background

Pediatric patients with facial fractures are a unique challenge in terms of their treatment planning, which is different from that of adult patients. Early literature has advocated conservative closed management of pediatric facial fractures to prevent complications. However, recent advances in treatment have enabled us to use biodegradable plates and screws, which overcome the limitations of metallic plates.

Aim

This study was conducted to evaluate the effectiveness of Inion CPS biodegradable plates and screws on pediatric facial fractures.

Patients and methods

The study was conducted on 30 pediatric patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection and comminuted fractures were excluded. Patients were aged 3–12 years, 18 boys and 12 girls, with different types of trauma: 12 patients had suffered falls, 12 patients had middle cerebral artery (MCA), four patients had sports-related fracture; and two patients had assault-related fractures. The site of fracture was different: 18 patients had mandibular fractures, four patients had zygomatic complex fractures, four patients had orbital fractures, two patients had maxillary fractures (one isolated and the other with mandibular fracture), and one patient had frontal bone and sinus fractures (anterior wall). Fractures were plated with a biodegradable system (Inion CPS) using standard plating principles. Postoperative complications were assessed.

Results

Satisfactory reduction was obtained in all patients, as judged from the position of the fracture segments in 24-h postoperative radiographs compared with all subsequently obtained images. The undisturbed reduction was considered as a marker of the stable fixation provided by the bioresorbable system. The screw holes visible as radiolucencies on the radiograph were also seen to maintain their position throughout the period of follow-up.

Conclusion

In our study, we concluded that the use of Inion bioresorbable plates is effective in the treatment of facial fracture in pediatric patients. There was no complication and no growth disturbance in the follow-up period, which proves that bioresorbable plates provide stable fixation in children. Our data support the use of bioresorbable plate fixation in pediatric craniofacial surgery as a means of avoiding the potential and well-documented problems associated with rigid metal fixation.

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