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Degradable polyglycolide rods for the internal fixation of displaced bimalleolar fractures

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Summary

Cylindrical biodegradable rods of self-reinforced polyglycolide were constructed for internal fixation of fractures in cancellous bone. The self-reinforced texture was achieved by embedding polyglycolide fibres in a polyglycolide matrix. In a prospective clinical study, 62 patients with displaced bimalleolar fractures were managed by open reduction and internal fixation using these rods. The results were assessed between 1.1 and 3.4 years from implantation. One wound infection occurred (1.6%). Five patients (8.1%) developed a sterile accumulation of fluid at the site of operation which required drainage: the final outcome was not affected. Minor displacement of the fracture (1–2 mm) occurred in nine patients (14.5%) but did not need further operation. The functional result was excellent in 39 patients (63%). This was considered acceptable given the severity of the fractures. Consequently, at our hospital, when a displaced malleolar fracture needs internal fixation biodegradable rods are now the treatment of choice. The psychological and financial advantages of avoiding implant removal are considerable.

Résumé

Des clous cylindriques biodégradables de polyglycolide renforcé ont été mis au point pour la synthèse des fractures en os spongieux. Le renforcement de la texture a été obtenu par enrobement de fibres de polyglycolide (Dexon) dans une matrice de polyglycolide. Une étude clinique prospective de 62 patients atteints de fractures bimalléolaires déplacées, traitées par réduction à ciel ouvert et synthèse utilisant ce type de clous a été réalisée. Les résultats ont été appréciés entre 13 mois et 40 mois après implantation. Une infection a été observée (1.6%), cinq malades (8.1%) ont présenté un épanchement stérile nécessitant un drainage de la zone opératoire. Le résultat final n'en a pas été affecté. Un minime déplacement (1 à 2 mm) s'est produit dans neuf cas (14.5%) mais n'a pas nécessité de réintervention. Le résultat fonctionnel a été excellent dans 39 cas (63%) ce qui peut être considéré comme acceptable compte tenu de la gravité de ces fractures. En conséquence la fixation par clous biodégradables des fractures bimalléolaires déplacées représente pour nous le traitement de choix. L'inutilité d'une ablation de matériel présente des avantages psychologiques et financiers considérables.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Central Hospital, SF-00260, Helsinki, Finland

    O. Böstman, E. Hirvensalo, S. Vainionpää, K. Vihtonen & P. Rokkanen

  2. Biomaterials Laboratory, University of Technology, SF-33101, Tampere, Finland

    P. Törmälä

Authors
  1. O. Böstman
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  2. E. Hirvensalo
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  3. S. Vainionpää
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  4. K. Vihtonen
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  5. P. Törmälä
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  6. P. Rokkanen
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Böstman, O., Hirvensalo, E., Vainionpää, S. et al. Degradable polyglycolide rods for the internal fixation of displaced bimalleolar fractures. International Orthopaedics 14, 1–8 (1990). https://doi.org/10.1007/BF00183354

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