Resorbable plate fixation in pediatric craniofacial surgery: long-term outcome

Abstract

Objective: To determine the long-term efficacy of resorbable plate fixation in pediatric patients undergoing craniofacial surgery for congenital anomalies, traumatic deformities, or skull base tumors.

Design: Retrospective case review.

Materials and methods: Medical records of 57 consecutive cases using resorbable plates and screws for craniofacial fixation in patients younger than 18 years were analyzed.

Main outcome measures: The status of bone healing postoperatively (anatomical union, malunion, delayed union, or nonunion) and any complications or adverse effects (hardware visibility or palpability, plate extrusion, or infection) were noted.

Results: In midfacial and upper face procedures (54 patients) anatomical union and uncomplicated bone healing occurred in 52 (96%) of the patients. In this same group, complications (plate extrusion) occurred in 2 patients (3.7%) and were resolved using conservative treatment without untoward sequelae. These outcomes are comparable to results using metal osteosynthesis in similar situations. Costs of resorbable hardware are similar to existing metal fixation systems.

Conclusions: Our data support the use of bioresorbable plate fixation in pediatric craniofacial surgery as a means of avoiding the potential and well-documented problems with rigid metal fixation. Indications include fractures and segmental repositioning in low-stress non-load-bearing areas of the middle and upper craniofacial skeleton. Although there is an initial learning curve in using this technology, we believe the benefits are well worth the effort and represent a major advance in pediatric craniofacial surgery.