Abstract
We reviewed 12 male patients with scaphoid nonunions treated by open reduction, bone grafting, and internal fixation with biodegradable implants made of self-reinforced 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-l-lactique auto-renforcé (SR-PLLA). L’âge moyen des malades était de 22.5 ans (20–25). 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 biodégradables est d’éliminer l’exigence d’ablation du matériel d’ostéosynthèse.
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Akmaz, I., Kiral, A., Pehlivan, O. et al. Biodegradable implants in the treatment of scaphoid nonunions. International Orthopaedics (SICOT) 28, 261–266 (2004). https://doi.org/10.1007/s00264-004-0580-z
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DOI: https://doi.org/10.1007/s00264-004-0580-z