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Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 8, pp 1069–1075 | Cite as

Fixation of medial malleolar fractures with magnesium bioabsorbable headless compression screws: short-term clinical and radiological outcomes in eleven patients

  • Ozkan KoseEmail author
  • Adil Turan
  • Melih Unal
  • Baver Acar
  • Ferhat Guler
Trauma Surgery

Abstract

Objective

The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures treated with magnesium (MgYREZr) bioabsorbable compression screw fixation.

Materials and methods

Eleven patients with a medial malleolar fracture (either isolated or accompanied by bimalleolar or trimalleolar ankle fractures) who were treated with magnesium bioabsorbable compression screws between 2015 and 2016 in our hospital were retrospectively evaluated. Patients were monitored with a mean follow-up of 17.3 ± 4.1 months (range 12–24 months). The mechanism of injury was ground level falls in all patients. All fractures were classified as closed fractures. American Orthopedic Foot and Ankle Society’s (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results during the final follow-up. Bone union and a possible loss of reduction were assessed with serial radiographs. Potential complications including revision surgery and infection were recorded and reported.

Results

There were 11 patients (4 female, 7 male) with a mean age of 41 ± 21.9 years (range 20–78 years). Six patients had Herscovici type C and five patients had type B fractures. At the final follow-up the mean AOFAS score was 94.9 ± 5.7 points (range 85–100 points) and the mean VAS score was 0.4 ± 1.2 points (range 0–4 points). Radiographic solid union was achieved in all cases. No complications were seen during the follow-up. No patients required implant removal or revision surgery.

Conclusions

This is the first study that investigates the use of bioabsorbable magnesium compression screws in medial malleolar fractures. The results of this study revealed that fixation of medial malleolar fractures with bioabsorbable magnesium compression screws provides adequate fixation with good functional results.

Level of evidence

Level IV, therapeutic, retrospective case series.

Keywords

Biodegradable implants Magnesium screws Ankle fractures Functional outcome Bioabsorbable implants 

Notes

Funding

No funds have been received for this study.

Compliance with ethical standards

Conflict of interest

Authors have no conflict of interest to declare.

References

  1. 1.
    Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37(8):691–697CrossRefPubMedGoogle Scholar
  2. 2.
    Herscovici D Jr, Scaduto JM, Infante A (2007) Conservative treatment of isolated fractures of the medial malleolus. J Bone Jt Surg 89B:89–93CrossRefGoogle Scholar
  3. 3.
    Lareau CR, Bariteau JT, Paller DJ, Koruprolu SC, DiGiovanni CW (2015) Contribution of the medial malleolus to tibiotalar joint contact characteristics. Foot Ankle Spec 8:23–28CrossRefPubMedGoogle Scholar
  4. 4.
    Hanhisuanto S, Kortekangas T, Pakarinen H, Flinkkilä T, Leskelä HV (2017) The functional outcome and quality of life after treatment of isolated medial malleolar fractures. Foot Ankle Surg 23(4):225–229CrossRefPubMedGoogle Scholar
  5. 5.
    Maniar H, Kempegowda H, Tawari AA, Rutter MR, Borade A, Cush G, Horwitz DS (2017) Medial malleoli fractures: clinical comparison between newly designed sled device and conventional screws. Foot Ankle Spec 10(4):296–301CrossRefPubMedGoogle Scholar
  6. 6.
    Collinge C, Dombroski D, Heier K (2016) Ankle fractures and dislocations. In: Stannard JP, Schmidt AH (eds) Surgical treatment of orthopaedic trauma. Thieme Publishers, New York, MD, pp 1018–1023Google Scholar
  7. 7.
    Brown OL, Dirschl DR, Obremskey WT (2001) Incidence of hardware-related pain and its effect on functional outcomes after open reduction and internal fixation of ankle fractures. J Orthop Trauma 15(4):271–274CrossRefPubMedGoogle Scholar
  8. 8.
    Naumann MG, Sigurdsen U, Utvåg SE, Stavem K (2016) Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: a retrospective cohort study of 997 patients. Injury 47(8):1783–1788CrossRefPubMedGoogle Scholar
  9. 9.
    Böstman O, Pihlajamäki H (1996) Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units. J Trauma 41(5):846–849CrossRefPubMedGoogle Scholar
  10. 10.
    Raikin SM, Ching AC (2005) Bioabsorbable fixation in foot and ankle. Foot Ankle Clin 10(4):667–684CrossRefGoogle Scholar
  11. 11.
    Seitz JM, Lucas A, Kirschner M (2016) Magnesium-based compression screws: a novelty in the clinical use of implants. JOM 68:1177–1182CrossRefGoogle Scholar
  12. 12.
    Plaass C, von Falck C, Ettinger S et al (2017) Bioabsorbable magnesium versus standard titanium compression screws for fixation of distal metatarsal osteotomies—3 year results of a randomized clinical trial. J Orthop Sci.  https://doi.org/10.1016/j.jos.2017.11.005 PubMedCrossRefGoogle Scholar
  13. 13.
    Plaass C, Ettinger S, Sonnow L et al (2016) Early results using biodegradable magnesium screw for modified chevron osteotomies. J Orthop Res 34(12):2207–2214.  https://doi.org/10.1002/jor.23241 CrossRefPubMedGoogle Scholar
  14. 14.
    Windhagen H, Radtke K, Weizbauer A et al. (2013) Biodegradable magnesium-based screw clinically equivalent to titanium screw in hallux valgus surgery: short term results of the first prospective, randomized, controlled clinical pilot study. Biomed Eng Online. 12:62.  https://doi.org/10.1186/1475-925X-12-62 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Biber R, Pauser J, Brem M, Bail HJ (2017) Bioabsorbable metal screws in traumatology: a promising innovation. Trauma Case Rep (8):11–15Google Scholar
  16. 16.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16(4):494–502.15CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Biber R, Pauser J, Geßlein M, Bail HJ (2016) Magnesium-Based Absorbable Metal Screws for Intra-Articular Fracture Fixation. Case Rep Orthop 2016:9673174PubMedPubMedCentralGoogle Scholar
  18. 18.
    Leonhardt H, Franke A, McLeod NMH, Lauer G, Nowak A (2017) Fixation of fractures of the condylar head of the mandible with a new magnesium-alloy biodegradable cannulated headless bone screw. Br J Oral Maxillofac Surg 55(6):623–625CrossRefPubMedGoogle Scholar
  19. 19.
    Meier R, Panzica M (2017) First results with a resorbable MgYREZr compression screw in unstable scaphoid fractures show extensive bone cysts. Handchir Mikrochir Plast Chir 49(1):37–41CrossRefPubMedGoogle Scholar
  20. 20.
    Wichelhaus A, Emmerich J, Mittlmeier T (2016) A Case of Implant Failure in Partial Wrist Fusion Applying Magnesium-Based Headless Bone Screws. Case Rep Orthop 2016:7049130PubMedPubMedCentralGoogle Scholar
  21. 21.
    Waizy H, Seitz JM, Reifenrath J et al (2013) Biodegradable magnesium implants for orthopedic applications. J Mater Sci 48:39–5020CrossRefGoogle Scholar
  22. 22.
    Böstman OM (1996) Metallic or absorbable fracture fixation devices. A cost minimization analysis. Clin Orthop Relat Res 329:233–239CrossRefGoogle Scholar
  23. 23.
    Weber BG, Colton C (1991) Malleolar fractures. In: Mueller ME, Allgower M, Schneider R, Willenegger H (eds) Manual of internal fixation: techniques recommended by the AO-ASIF Group, 3rd edn. Springer, New York, pp 595–612CrossRefGoogle Scholar
  24. 24.
    Barnes H, Cannada LK, Watson JT (2014) A clinical evaluation of alternative fixation techniques for medial malleolus fractures. Injury 45(9):1365–1367CrossRefPubMedGoogle Scholar
  25. 25.
    Tekin A, Çabuk H, Dedeoğlu SS et al (2016) Anterograde headless cannulated screw fixation in the treatment of medial malleolar fractures: evaluation of a new technique and its outcomes. Med Princ Pract 25(5):429–434CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopedics and Traumatology, Antalya Training and Research HospitalUniversity of Health SciencesAntalyaTurkey

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