The economic costs of ankle fractures treated operatively with self-reinforced polyglycolide acid (SR-PGA) screws, with self-reinforced poly-L-lactide acid (SR-PLLA) screws or with metallic implants was determined. All patients were divided into three groups according to the fixation material used. Open and otherwise complicated fractures were excluded. The total expense of operations in each group was taken into account. The average total cost of an ankle fracture fixed with SR-PGA screws was Pounds 3503. In the SR-PLLA group it was Pounds 3906, and in the metallic group it was Pounds 4514. Total expenses were Pounds 1011 higher in the metallic group than in the SR-PGA group, and consequently, expenses in the metallic group were Pounds 608 higher than in the SR-PLLA group. According to this study, it seems that absorbable fixation devices are more economical than metallic implants in operative treatment of ankle fractures though as part of the differences in total expense in this series is due to the age of the patients and other dissimilarities between these groups, the results have to be interpreted carefully.
In connection with osteosynthesis carried out on the tibias of rats we compared acrylic and bis-GMA plastics (CMW and Silar) and acrylic emulsion and acrylic dispersion used as intermediary material. A total of 80 rats of both sexes were used. The rats were divided into four groups, in which different intermediary material combinations were tested. The observation times were 1, 3, 6, 12, and 24 weeks. Macroscopical, radiological, histological, oxytetracycline fluorescence, and scanning electron-microscopical studies were done. Histologically, the Silar proved to be the more reliable fixation material and acrylic dispersion the better intermediary material. Furthermore, the radiological results were better (P less than 0.05) when acrylic dispersion was used as the intermediary material and Silar as the plastic.
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