Use of biomaterials in scaphoid fracture fixation, a systematic review

Feeley, Aoife; Feeley, Iain; Fhoghlu, Cliodhna Ní; Sheehan, Eoin; Kennedy, M.T.

doi:10.1016/j.clinbiomech.2021.105480

Cited by 5 publications

(12 citation statements)

References 51 publications

(101 reference statements)

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“…Complication rates were reported to be between 21 and 26%, depending on the graft used [ 23 , 37 , 39 ]. The meta-analysis by Feeley et al [ 2 ] regarding the use of bioabsorbable fixation methods revealed 23% complications, and the SWIFFT study reports 14% in the surgical group [ 14 ]. Reigstad et al [ 24 ] described increased arthrosis around the implanted screw.…”

Section: Discussionmentioning

confidence: 99%

“…Keller et al [ 23 ] reported implant irritation which healed only after implant removal. Biomaterials are one alternative, but these materials and their degradation products may interfere with bone healing [ 2 ]. 21,000 hardware removals were performed in Austria in 2016 (personal communication, Gebietskrankenkasse Oberösterreich).…”

Section: Discussionmentioning

confidence: 99%

“…Allograft use for scaphoid reconstruction was described for the first time by Carter et al [ 1 ] using Herbert screws (metal screws) for fixation. The necessity of metallic screw removal is under debate [ 2 ]. Wang et al [ 3 ] described that 89% of patients insisted on screw removal because of their cultural belief.…”

Section: Introductionmentioning

confidence: 99%

“…Others report that screw removal was required owing to pain at the scaphotrapezial joint [ 4 ], and removal rates of 8–14% have been reported [ 5 ]. The use of biomaterials in scaphoid fracture fixation was described [ 2 ] as leading to union rates of between 64 and 100%, but no human allogeneic cortical bone screws were described in that review. At the same time, Manako et al [ 6 ] used autologous bone screws with good integration over time [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of scaphoid fractures and pseudarthroses with the human allogeneic cortical bone screw. A multicentric retrospective study

Sailer¹,

Lechner²,

Floßmann

et al. 2023

J Orthop Traumatol

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Background Allograft bone screws are rarely described for the fixation of the scaphoid. When fresh fractures are treated, metal screws are mainly used; when pseudarthrosis is the indication, plates in combination with vascularized or non-vascularized bone grafts are mainly used. The necessity of metallic screw removal is under debate, but it is mandatory for plates because of movement restrictions due to the plate. The use of biomaterials in scaphoid fracture fixation was described as leading to union rates of between 64 and 100%. Brcic showed the incorporation of an allogeneic cortical bone screw at 10 weeks postoperative, along with revascularization and stable osteosynthesis with primary bone healing, without any signs of immunological rejection. The purpose of this retrospective study was to explore the results obtained using an allogenic cortical bone screw (Shark Screw®) in patients with fresh scaphoid fracture fixation and pseudarthroses with respect to union rates and time to union. Patients and methods We retrospectively analyzed 75 patients: 31 with fresh fractures and 44 pseudarthrosis patients. The Shark Screw® was used for the fixation of the scaphoid in the fresh-fracture and pseudarthrosis patients. We evaluated the union rate, complication rate and time to union. Results Using the human allogeneic cortical bone screw for scaphoid fracture fixation led to a high union rate (94–96%). There were two nonunions in the fresh fracture group and two nonunions in the pseudarthrosis group. The complication rate was 1.3% (1 patient). Median time to union was 16, 18 and 29 weeks for the fresh-fracture, pseudarthrosis and delayed-union patients, respectively. The treatment of fresh scaphoid fractures and pseudarthroses showed similar union rates to those described in the literature, uses a shorter and less invasive surgical method with no need for hardware removal, and has a low complication rate. Conclusion Using the human allogenic cortical bone screw (Shark Screw®) led to similar union rates in fresh fractures—but better union rates in pseudarthrosis patients—compared to those presented in the literature for other scaphoid fracture fixation techniques, and it enabled a short and low-invasive procedure without any donor site morbidity and without the necessity to remove the hardware in a second surgery. The pseudarthrosis patient group showed a particularly strong benefit from this new procedure. The physiological bone metabolism remodels the cortical bone screw without scars. Level of evidence: III: retrospective cohort study, therapeutic investigation of a treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of scaphoid fractures and pseudarthroses with the human allogeneic cortical bone screw. A multicentric retrospective study

Sailer¹,

Lechner²,

Floßmann

et al. 2023

J Orthop Traumatol

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“…Commercial bioabsorbable implants made from polymers were used for osteosynthesis [ 42 , 43 ]. Polymers such as poly-L-lactic acid (PLLA) or poly-lactic-co-glycolic acid (PLGA) are characterized by high brittleness, a low property of osteoconductivity, and a long degradation rate.…”

Section: Biocompatible Implants Used In Pediatric Osteochondral Fract...mentioning

confidence: 99%

Treatment of Knee Osteochondral Fractures

et al. 2022

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Osteochondral lesions (OCLs) that are frequently encountered in skeletally immature and adult patients are more common than once thought, and their incidence rate is rising. These lesions can appear in many synovial joints of the body, such as the shoulder, elbow, hip, and ankle, occurring most often in the knee. The term osteochondral lesion includes a vast spectrum of pathologies such as osteochondritis dissecans, osteochondral defects, osteochondral fractures, and osteonecrosis of the subchondral bone. When considering this, the term osteochondral fracture is preserved only for an osteochondral defect that combines disruption of the articular cartilage and subchondral bone. These fractures commonly occur after sports practice and are associated with acute lateral patellar dislocations. Many of these lesions are initially diagnosed by plain radiographs; however, a computed tomography (CT) scan or magnetic resonance imaging (MRI) can add significant value to the diagnosis and treatment. Treatment methods may vary depending on the location and size of the fracture, fragment instability, and skeletal maturity. The paper reports a 14-year-old boy case with an osteochondral fracture due to sports trauma. The medical approach involved an arthrotomy of the knee, drainage of the hematoma, two Kirschner wires (K-wires) for temporary fixation to restructure anatomic alignment, and a titanium Herbert screw fixing the fracture permanently. The patient had a favorable postoperative outcome with no residual pain, adequate knee stability, and a normal range of motion. The mobility of the knee was fully recovered.

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Surgical Treatment of Scaphoid Fractures: Recommendations for Management

Samade,

Awan

2024

J Wrist Surg

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Background: Several operative treatments exist for scaphoid fractures, varying by approach (e.g., ercutaneous, volar, or dorsal), implant type (e.g., screw or Kirschner wire), and bone raft choice (e.g., none, nonvascularized, or vascularized). Many previous systematic eviews and meta-analyses have investigated outcomes following different surgicalÚpproaches, the use of vascularized versus nonvascularized bone graft for scaphoidßracture nonunions, and treatment for specific fracture patterns. However, given the advancements n scaphoid fracture treatment in recent years, there is a need for updated treatment recommendations hat would be beneficial to hand surgeons. Purpose: We present a comprehensive review of the operative treatment of scaphoid fractures based on recent literature and propose a unified treatment algorithm for managing these fractures. Methods: The English-language literature was searched from 2002 to 2023 for high evidence level (e.g., randomized trials), review, and meta-analysis articles with the following search terms: “scaphoid, ”u8220“scaphoid” AND “nonunion, ” and “scaphoid” AND “malunion. ” Each article was creened by the authors to determine the scaphoid fracture scenario addressed and ubsequent treatment recommendations. The findings from article reviews were then rganized by scaphoid fracture types in this manuscript. Results: A total of 95 pertinent articles were ultimately selected and used as the basis for reviewing different scaphoid fracture scenarios. A treatment algorithm was then proposed based on literature review. Conclusion: This summary of the recent literature can guide hand surgeons in addressing scaphoidßractures. Future research in scaphoid fracture treatment, particularly for nonunions, would be most beneficial n the form of systematic review, meta-analysis, or multicenter prospective randomized clinical trials. Level of Evidence: IV

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Use of biomaterials in scaphoid fracture fixation, a systematic review

Cited by 5 publications

References 51 publications

Treatment of scaphoid fractures and pseudarthroses with the human allogeneic cortical bone screw. A multicentric retrospective study

Treatment of scaphoid fractures and pseudarthroses with the human allogeneic cortical bone screw. A multicentric retrospective study

Treatment of Knee Osteochondral Fractures

Surgical Treatment of Scaphoid Fractures: Recommendations for Management

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