PDF(Pubmed)
Abstract：
Background: Pediatric forearm fractures represent a substantial proportion of childhood injuries, requiring effective and minimally invasive treatments. Our study investigated the mid-term outcomes of biodegradable poly-L-lactide-co-glycolide (PLGA) intramedullary implants in managing diaphyseal forearm fractures in children. Methods: A follow-up cohort study was conducted with 38 patients treated with PLGA implants. Control examinations were performed one year post-operation, assessing bone healing through radiographic evaluations and functional outcomes using injured and uninjured limb range of motion (ROM) comparisons. Scarring was evaluated employing the Vancouver Scar Scale (VSS), and satisfaction via a questionnaire. Results: Children were predominantly female (76.4%), with a mean age of 9.71 (SD: 2.69) years. Effective fracture stabilization and bone healing were found in all patients, with a minor reduction (mean difference of -1.5°, p = 0.282) in elbow flexion on the operated side (139.3°) compared to the intact (140.8°). Elbow extension presented negligible average changes (0.2°, p = 0.098). Forearm movements were slightly reduced on the operated side (mean pronation: 80.8° vs. 83.7°, p = 0.166; average supination: 83.5° vs. 85.7°, p = 0.141). Wrist palmar flexion and dorsiflexion showed no significant differences. VSS ratings indicated minimal scarring (mean guardian and doctor scores were 1.13 and 0.55, respectively, p = 0.020), and all patients reported satisfaction with the treatment outcomes. Conclusions: Biodegradable implants are effective for pediatric forearm fractures, providing stable bone healing while preserving functional ROM with minimal scarring and high patient satisfaction. PLGA proved to be a viable alternative to traditional metal implants, eliminating secondary removal surgeries.
摘要：
背景：小儿前臂骨折占儿童损伤的很大比例，需要有效和微创治疗。我们的研究调查了可生物降解的聚-L-丙交酯-共-乙交酯（PLGA）髓内植入物治疗儿童骨干前臂骨折的中期结果。方法：对38例接受PLGA植入物治疗的患者进行了随访队列研究。术后一年进行对照检查，使用受伤和未受伤的肢体活动范围（ROM）比较，通过影像学评估和功能结果评估骨愈合。疤痕采用温哥华疤痕量表(VSS)进行评估，通过问卷调查和满意度。结果：儿童以女性为主（76.4%），平均年龄9.71（SD：2.69）岁。所有患者均发现有效的骨折稳定和骨愈合，稍有降低(平均差-1.5°，p=0.282）在操作侧的肘部弯曲（139.3°）与完整（140.8°）相比。弯头延伸呈现可忽略的平均变化(0.2°，p=0.098)。前臂运动在手术侧略有减少（平均内旋：80.8°vs.83.7°,p=0.166；平均旋后：83.5°vs.85.7°,p=0.141）。手腕掌屈和背屈没有显着差异。VSS评分显示疤痕最小（平均监护人和医生评分分别为1.13和0.55，p=0.020),所有患者均报告对治疗结果满意.结论：生物可降解植入物对小儿前臂骨折有效，提供稳定的骨愈合，同时保留功能ROM，具有最小的疤痕和高的患者满意度。PLGA被证明是传统金属植入物的可行替代品，消除二次切除手术。
