Midterm comparative result of absorbable screws and metal screws in pediatric medial humeral epicondyle fracture

Abstract

Backgroud

Medial humeral epicondyle fracture is a prevalent type of upper limb fractures in pediatric patients. This study aims to compare the follow-up clinical results and complications in 30 children with medial epicondyle fractures who were treated with either metal screws or absorbable screws at our hospital.

Methods

A retrospective review was conducted on 30 children with medial humeral epicondyle fractures, who were divided into two groups: Metal group (18 children) underwent fixation using metal screws, while Absorbable group (12 children) received absorbable screws between January 2016 and June 2024. We collected the operation time and the length of incision of each patient. All the patients were followed up for over 20 months. Clinical outcomes were assessed and compared using elbow range of motion (ROM), mayo elbow performance score (MEPS) and range of rotation (ROR) during the last follow-up visit. Additionally, pain levels measured by a 10-point visual analog scale (VAS) and complications were duly documented.

Results

In terms of operative time, length of incision, and VAS scores, no significant differences were observed (p > 0.05). The patients were followed up at an average of 33.1 months (range, 22–49 months). The mean MEPS were 89.44 ± 3.79 and 89.58 ± 3.34 (p = 0.89), the mean ROM were 122.28 ± 5.87 and 125.1 ± 5.83 (p = 0.27), and the mean ROR were 153.33 ± 5.94 and 155.83 ± 5.15 (p = 0.26) in groups A and B, respectively. In addition, two children in Metal group experienced symptoms of screw stimulation, while Absorbable group did not.

Conclusion

The use of absorbable screws in treating pediatric medial epicondyle fractures can yield equivalent therapeutic outcomes to traditional metal screws, obviating the need for subsequent surgical interventions and mitigating complications associated with screw irritation resulting from non-degradable metallic implants.