Bioabsorbable pins, sutures successfully treated medial humeral epicondyle fractures
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Published results showed use of bioabsorbable pins with tension band absorbable sutures achieved positive functional and radiological results with no major complications in pediatric patients with medial humeral epicondyle fractures.
In a retrospective cohort study, Tamás Kassai, MD, and colleagues analyzed data on 24 children (mean age of 12.3 years at the time of injury) who received biodegradable implants (ActivaPin, Bioretec) and tension band polydioxanone sutures for medial humeral epicondyle fractures between January 2016 and January 2019. According to the study, nine patients had a fracture with joint dislocation and incarceration and 15 patients had an avulsion fracture with displacement. Postoperative outcome measures included degree of anatomic reduction and nonunion or fragmentation confirmed by X-ray.
At 4 weeks, all 24 patients displayed callus formation on X-ray, and range of motion of the elbow was “almost complete” in all patients at 6 months. Researchers noted one patient developed transient ulnar nerve palsy, which resolved by 4 months postoperatively.
“We suggest this method because it does not require a secondary (metal removal) operation,” the researchers wrote in the study.
However, Kassai and colleagues cautioned surgeons to focus on pin placement and technique.
“Positioning the bioabsorbable pins in the place of the previously drilled wires requires careful technique, which can increase the time of the procedure,” they wrote. “Because the pins are almost invisible under fluoroscopy, they should be inserted after an accurate measurement. If the ends of the pins go far beyond the opposite cortical bone and protrude laterally, soft tissue or the radial nerve may be irritated,” they concluded.
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