Osteochondral fractures, involving both cartilage and underlying bone, present significant challenges due to their impact on joint function and potential for long-term complications. Traditional metallic fixations, such as K-wires, are effective but can lead to complications, including infection and hardware irritation. In such scenarios, bioabsorbable materials can be an alternative. This case series explores the use of bioabsorbable K-wires for osteochondral fracture fixation in the elbow, distal femur, and patella, focusing on functional outcomes and clinical insights. Four cases involving pediatric patients with osteochondral fractures were reviewed. Cases included a 16-year-old dancer with a distal femur and patella fracture, a 12-year-old girl with an elbow fracture, and two 14-year-old girls with knee injuries. Surgical interventions used bioabsorbable K-wires for fixation, with follow-up assessments including imaging and functional evaluations at 6 and 12 months. Case 1: The 16-year-old dancer diagnosed with osteochondral fracture of the lateral femoral condyle achieved full range of motion (ROM) and walked without discomfort at 6 months post-surgery. Magnetic resonance imaging (MRI) ruled out avascular necrosis (AVN) of the osteochondral fragment. Case 2: The 12-year-old girl with an osteochondral fracture of the capitulum had a full, painless ROM by 2 months post-operation and resumed daily activities without pain at 6 months. Case 3: The 14-year-old girl with a knee injury regained full ROM by 3 months, and an MRI at 6 months showed successful healing of the osteochondral injury. Case 4: The 12-year-old girl with a patellar dislocation and osteochondral fracture patella had a full ROM and no pain at 2 months post-surgery, and there was no evidence of AVN at 6 months. Bioabsorbable K-wires are an alternative fixation option for osteochondral fractures. Despite potential issues such as non-infectious inflammatory reactions and osteolysis, these materials can be used in pediatric orthopedic surgery. Further research with larger sample sizes is warranted to fully assess long-term outcomes and optimize their use.
Jyothiprasanth et al. (Wed,) studied this question.