Bioabsorbable miniplating versus metallic fixation for metacarpal fractures.
Bioabsorbable implants offer an attractive alternative to metallic implants to stabilize small bone fractures in the hand. Self-reinforced bioabsorbable miniplating for metacarpal fractures was studied in bones from cadavers and compared with standard metallic fixation methods. One hundred twelve fresh-frozen metacarpals from humans had three-point bending and torsional loading after transverse osteotomy followed by fixation using seven methods: (1) dorsal and (2) dorsolateral 2-mm self-reinforced polylactide-polyglycolide 80/20 plating, (3) dorsal and (4) dorsolateral 2-mm self-reinforced poly-L/DL-lactide 70/30 plating, (5) dorsal 1.7-mm titanium plating, (6) dorsal 2.3-mm titanium plating, and (7) crossed 1.25-mm Kirschner wires. In apex dorsal and palmar bending, dorsal self-reinforced polylactide-polyglycolide and poly-L/DL-lactide plates provided stability comparable with dorsal titanium 1.7-mm plating. When the bioabsorbable plates were applied dorsolaterally, apex palmar rigidity was increased and apex dorsal rigidity was decreased. Bioabsorbable platings resulted in higher torsional rigidity than 1.7-mm titanium plating and in failure torque comparable with 2.3-mm titanium plating. Low-profile selfreinforced polylactide-polyglycolide and poly-L/DL-lactide miniplates provide satisfactory biomechanical stability for metacarpal fixation. These findings suggest that bioabsorbable miniplating can be used safely in the clinical stabilization of metacarpal and phalangeal fractures.
Waris
Eero
E
Institute of Biomedicine/Anatomy, Biomedicum Helsinki, University of Helsinki, Finland. eero.waris@helsinki.fi
Ashammakhi
Nureddin
N
Happonen
Harri
H
Raatikainen
Timo
T
Kaarela
Outi
O
Törmälä
Pertti
P
Santavirta
Seppo
S
Konttinen
Yrjö T
YT
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries*; D008875:Middle Aged; D011091:Polyesters; D011100:Polyglycolic Acid; D014102:Torsion Abnormality
D011091:Polyesters; D011100:Polyglycolic Acid; C033616:poly(lactide)