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Long-term Outcome

Mario J. Imola, MD, DDS, FRCSC; David D. Hamlar, MD, DDS; Weiru Shao, MD; Khalid Chowdhury, MD, FRCSC; Sherard Tatum, MD

Arch Facial Plast Surg. 2001;3:79-90.

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.

From the Center for Craniofacial–Skull Base Surgery, Denver, Colo (Drs Imola and Chowdhury); Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Minneapolis (Drs Imola, Hamlar, and Shao); and Department of Otolaryngology and Pediatric Medicine, State University of New York, Syracuse (Dr Tatum). The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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