Pediatric medial humeral epicondyle fracture in children: Are biodegradable pins with tension band absorbable sutures efficient?

Abstract

Medial humeral epicondyle fractures account for 10% to 20% of elbow injuries in children. We hypothesized that in the fixation of medial humeral epicondyle fractures, safety and efficiency of bioabsorbable poly(l-lactide-co-glycolic acid) implant are comparable to traditional metallic and other novel approaches.A retrospective cohort study was performed between 2016 and 2019, analyzing 24 children who had medial humeral epicondyle fractures. Every fracture was stabilized with biodegradable poly(l-lactide-co-glycolic acid) implants (Bioretec® ActivaPin®) and tension band polydioxanone sutures. Indications for surgery included closed fractures with >1 cm dislocation and incarcerated fractures. Postoperatively, the degree of anatomic reduction and the presence or absence of nonunion or fragmentation were confirmed with X-rays. In this clinical study, we evaluated the operation time, age, and gender distribution.The mean age at the time of injury was 12.3 (8–16 years). In the fourth week, every patient’s X-ray showed callus formation, and the range of motion of the elbow after 6 months of the operation was almost complete in all children. Transient ulnar nerve palsy was developed in 1 patient, which was spontaneously resolved in the fourth postoperative month. No other complications were observed during the average follow-up period of 34 months (16–60 months).Bioabsorbable pins with absorbable sutures are a good alternative treatment of medial epicondyle humeral fracture. No permanent complications were noted while using this technique. We suggest this method because it does not require a secondary (metal removal) operation.