[Osteosynthesis of distal radius fractures with biodegradable fracture rods. Results of two years follow-up].
Forty distal fractures of the radius were stabilized with biodegradable polyglycolic acid rods (Biofix). A forearm plaster cast was fit for 4 weeks. Nine patients developed late (4 to 16 weeks) aseptic inflammatory reactions at the pin site, which were treated by débridement. The histological specimens showed giant-cell phagocytosing fragmented polyermic debris. In two cases a bacterial wound infection occurred secondary to débridement. All local reactions healed within 4 weeks. A classification system and treatment regimen for these inflammatory reactions are proposed. Thirty-four patients (including those with local foreign body reaction) were available for the 2-year follow-up. The anatomical results of fracture reduction on the postoperative and follow-up radiograms were the same, confirming good mechanical fracture stabilization. According to the Sarmiento score, the overall results were excellent and good in 31 cases. In one of the three fair cases, the result was clearly due to the initial local foreign-body reaction. Because of the high incidence of local inflammatory reaction, for now clinical application of biodegradable implants seems problematic despite the good overall 2-year results. This should only be advocated for well-controlled prospective studies using implants with improved biocompatibility.
Hoffmann
R
R
Unfallchirurgische Klinik, Medizinischen Hochschule Hannover.
Krettek
C
C
Hetkämper
A
A
Haas
N
N
Tscherne
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000209:etiology*; D011885:Radius Fractures / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology; D014954:Wrist Injuries / Q000601:surgery*
D011100:Polyglycolic Acid
Osteosynthese distaler Radiusfrakturen mit biodegradablen Frakturstiften. Zweijahresergebnisse.