Outcomes and complications of metallic vs. bioabsorbable screw fixation for displaced medial epicondylar fractures in pediatric and adolescent patients.

PURPOSE: The use of bioabsorbable screws in orthopedics and trauma surgery is increasing. The major advantage of not having to remove the implant is of particular interest in pediatric surgery. Due to drawbacks, most notably implant fracture, bioabsorbable screw osteosynthesis has not yet surpassed the gold standard of metallic screw osteosynthesis. This single-centre study compares metallic screw and bioabsorbable screw osteosynthesis of medial humeral epicondyle fractures in children and adolescents over a two-year period.

MATERIALS AND

METHODS

Retrospective analysis of surgically treated (screw fixation with either bioabsorbable magnesium-based or metallic screw) patients with a medial humeral epicondyle fracture between 2020 and 2022 at the author's institution.

RESULTS

Seventeen patients with medial epicondyle fractures underwent surgical treatment using either bioabsorbable screws (n = 8) or metallic screws (n = 9). Baseline characteristics, surgical approach, and postoperative care were similar between groups. Two complications (Clavien-Dindo I) occurred in the bioabsorbable group due to implant failure (screw breakage), though without clinical sequelae. These implant failures led to a significantly increased number of postoperative radiographs in the bioabsorbable group (median 4.8 vs. 2.5; p = 0.014). Functional outcomes (LOM, MEPI) and follow-up durations were comparable between groups.

CONCLUSION

Bioabsorbable screws appear to be a promising alternative to conventional metallic fixation in the treatment of pediatric medial epicondyle fractures. Although screw breakage-and the associated increase in radiographic surveillance-remains a notable concern, advances in biomaterial technology may help reduce this complication in the future.