Biodegradable implants in the treatment of scaphoid nonunions

Abstract

We reviewed 12 male patients with scaphoid nonunions treated by open reduction, bone grafting, and internal fixation with biodegradable implants made of selfreinforced poly-L-lactic acid. Mean patient age was 22.5 (20-25) years. Ten patients had type D2 scaphoid nonunions with a fracture line in the middle one third, one patient had type D2 nonunion with a fracture line in the proximal one third, and one patient had type D1 distal one-third fibrous union. The mean wrist score (modified Mayo wrist score) was 20.8 (10-40) preoperatively and improved after 22-80 months (55-90). All nonunions healed, and the mean solid union time was 4.5 (3.5-7) months. We obtained excellent results in five patients, good results in four, fair results in two, and a poor result in one. The results of this study offer a valid alternative in the fixation of scaphoid nonunions. The major advantage of biodegradable materials is to eliminate the requirement for the removal of the fixation material.Résumé Nous avons examiné douze malades de sexe masculin avec une non-consolidation du scaphoïde traitée par réduction ouverte, greffe osseuse et fixation interne avec des implants biodégradables faits d'acide poly-Llactique auto-renforcé (SR-PLLA). L'âge moyen des malades était de 22.5 ans (20)(21)(22)(23)(24)(25). Dix malades avaient une non-consolidation de type D2 avec le trait de fracture dans le tiers central, un malade avait le type D2 avec un trait de fracture dans le tiers proximal et un malade avait le type distal D1 avec union fibreuse. Le score moyen du poignet (Mayo wrist score modifié) était 20.8 (10-40) en préopératoire et amélioré après 22 mois à 80 (55-90). Toutes les nonunions ont consolidées dans un temps moyen de 4.5 mois (3.5-7). Nous avons obtenu d'excellents résultats chez cinq malades, de bons résultats chez quatre, des résultats médiocres chez deux et un résultat mauvais pour une. Les résultats de cette étude offrent une alternative valide pour la fixation des non-consolidations du scaphoïde. L'avantage majeur des matières biodégrad-ables est d'éliminer l'exigence d'ablation du matériel d'ostéosynthèse.

Degradable polymeric materials for osteosynthesis: Tutorial

“…Degradable polymeric materials for osteosynthesis (Akmaz et al, 2004). For fixation of bone fractures in regions of low load, the investigation shows that the higher chemical strength and loading capacity of PLDLLA 80:20, due to higher crystallinity is advantageous for long term implantation.…”

Fabrication and characterization of poly(octanediol citrate)/gallium-containing bioglass microcomposite scaffolds

“…Certain biomaterials can repair or replace damaged or diseased tissue by mimicking the natural extracellular matrix (ECM) [4]. Bio-resorbable scaffolds degrade in situ and minimize the need for additional surgery to remove the implant [5]. An ideal scaffold should degrade at a rate compatible with the rate of bone growth, physically creating open space for new bone formation until full regeneration is achieved.…”

The results of autologous bone graft and titanium headless cannulated compression screw for treatment of scaphoid nonunion

“…[18,24,31,[33][34][35] Çalışma-mızda, kaynama gerçekleşen 22/24 hastanın klinik değerlen-dirilmesinde kullanılan Mayo el bilek skorlamasına göre hastalarda iyi ve mükemmel sonuçlar alındı.…”