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Resorbable Versus Titanium Hardware for Rigid Fixation of Pediatric Upper and Midfacial Fractures: Which Carries a Lower Risk Profile?
- Source :
- Journal of Oral and Maxillofacial Surgery. 79:2103-2114
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Titanium associated risks have led to interest in resorbable hardware for open reduction and internal fixation (ORIF) of pediatric facial fractures. This study aims to systematically review and compare the outcomes of titanium/resorbable hardware used for ORIF of upper/midfacial fractures to determine which hardware carries a higher complication rate in the pediatric patient.Studies published between 1990 and 2020 on the ORIF of pediatric upper/midfacial fractures were systematically reviewed. A retrospective institutional review was also conducted, and both arms were compiled for final analysis. The primary predictor value was the type of hardware used and the primary outcome was the presence of a complication. Fisher's exact test and 2-proportion 2-tailed z-test calculations were used to determine statistical significance, which was defined as a P value.05. The low quality of published evidence precluded meta-analysis.Systematic review of 23 studies identified 659 patients, and 77 patients were identified in the institutional review. A total of 736 patients (299 resorbable, 437 titanium) were included in the final analysis. Total complication rate was 22.8%. The titanium group had a higher complication rate (27 vs 16.7%; P.01), and more often underwent elective hardware removal (87.3 vs 0%, P.01). In each hardware subgroup, the incidence of complications was analyzed by fracture site. In the titanium group, complication incidence was higher when treating maxillary fractures (32.8 vs 22.9%, P = .03). When comparing the 2 hardware groups by fracture site, maxillary fractures had a higher rate of complications when treated by titanium hardware compared with resorbable hardware (32.8 vs 18%, P.01).Upper/midfacial pediatric fractures requiring ORIF, especially maxillary fractures, may be best treated with resorbable hardware. Additional hardware-specific outcomes data is encouraged.
- Subjects :
- medicine.medical_treatment
Lower risk
Fracture Fixation, Internal
03 medical and health sciences
0302 clinical medicine
Statistical significance
Humans
Medicine
Internal fixation
Child
Reduction (orthopedic surgery)
Retrospective Studies
Fixation (histology)
Titanium
Skull Fractures
business.industry
030206 dentistry
Open Fracture Reduction
Exact test
Treatment Outcome
Otorhinolaryngology
030220 oncology & carcinogenesis
Maxillary Fractures
Surgery
Oral Surgery
business
Complication
Computer hardware
Subjects
Details
- ISSN :
- 02782391
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- Journal of Oral and Maxillofacial Surgery
- Accession number :
- edsair.doi.dedup.....7a026c30c08e4d0bd2c2c99fa1131e20