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Magnesium-Based Compression Screws in Acute Scaphoid Fractures and Nonunions

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Abstract

Background

Magnesium-based bioabsorbable osteosynthesis material continues to receive increasing attention. The following study documents our experience with bioabsorbable magnesium screws in scaphoid fracture treatment in hopes to capture further evidence and successful application.

Methods

Eight acute scaphoid fractures and four nonunions were treated with the magnesium-based bioabsorbable compression screw MAGNEZIX®. Objective outcome was assessed by X-ray imaging and/or CT scan for bone healing. Clinical assessment was achieved using the modified Mayo Wrist Score. Patient-reported outcome measure was performed threefold via QuickDASH, PRWE, and EQ-5D-5L questionnaires in all patients. Follow-up was 32.5 months (SD 18.7) in the acute fracture group and 31 months (SD 7.4) in the nonunion group.

Results

Bone healing was achieved in all eight patients with acute scaphoid fractures and in three of four patients with scaphoid nonunion. The modified Mayo Wrist Score was 95 (SD 7.1) in fractures and 80 (SD 7.1) in nonunion patients during follow-up. QuickDASH score was 3.9 (SD 5.8) in fracture and 19.3 (SD 10.6) in nonunion patients. All but one patient (87,5%) with scaphoid fractures presented with a full health state during follow-up (EQ-5D-5L). Nonunion patients had problems in 10 out of 19 dimensions in EQ-5D-5L. Acute fractures presented with a score of 3.9 (SD 7.9) and nonunions with a score of 19.7 (SD 32.4) in PRWE total scoring during follow-up.

Conclusions

Magnesium-based implants have excellent clinical outcomes when used for scaphoid fractures in eight presented cases and good to moderate clinical outcomes when used for nonunions in three of four presented cases. Additional studies are required to further analyze the differentiated applicability in scaphoid nonunion as well as overall performance when compared to non-absorbable screws in larger cohorts.

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References

  1. Joeris A, Goldhahn S, Rometsch E et al (2017) Titanium or steel as osteosynthesis material: systematic literature search for clinical evidence. Unfallchirurg 120:96–102

    Article  PubMed  Google Scholar 

  2. Kosugi K, Zenke Y, Tajima T et al (2020) Long-term outcomes of metacarpal fractures surgically treated using bioabsorbable plates: a retrospective study. BMC Musculoskelet Disord 21:817

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jung BT, Kim WH, Park B et al (2020) Biomechanical evaluation of unilateral subcondylar fracture of the mandible on the varying materials: a finite element analysis. PLoS ONE 15:e0240352

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Stroud CC (2002) Absorbable implants in fracture management. Foot Ankle Clin 7:495–499

    Article  PubMed  Google Scholar 

  5. Spitalny AD (2006) Bioabsorbable implants. Clin Padiatr Med Surg 23:673–694

    Article  Google Scholar 

  6. Atkinson HD, Khan S, Lashgari Y, et al (2019) Hallux valgus correction utilising a modified short scarf osteotomy with a magnesium biodegradable or titanium compression screws–a comparative study of clinical outcomes. BMC Musculoskelet Disord 20:334–019

  7. Klauser H (2019) Internal fixation of three-dimensional distal metatarsal I osteotomies in the treatment of hallux valgus deformities using biodegradable magnesium screws in comparison to titanium screws. Foot Ankle Surg 25:398–405

    Article  PubMed  Google Scholar 

  8. Schädel-Höpfner M, Bickert B, Dumont C et al (2016) Die frische Skaphoidfraktur. Orthopade 45:945–950

    Article  PubMed  Google Scholar 

  9. Dias JJ, Brealey SD, Fairhurst C et al (2020) Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial. Lancet 396:390–401

    Article  PubMed  Google Scholar 

  10. Wang J-P, Huang H-K, Shih J-T (2020) Arthroscopic-assisted reduction, bone grafting and screw fixation across the scapholunate joint for proximal pole scaphoid nonunion. BMC Musculoskelet Disord 21:834–020

  11. Meier R, Panzica M (2017) Erste Ergebnisse mit einer resorbierbaren MgYREZr-Kompressionsschraube bei der instabilen Kahnbeinfraktur zeigen eine massive Zystenbildung. Handchir Mikrochir Plast Chir 49:37–41

    Article  PubMed  Google Scholar 

  12. Könneker S, Vogt PM (2020) Comment on ‘Is bio absorbable screw really reliable for midcarpal arthrodesis? A literature review illustrated by a case report.’ Hand Microsurg 9:181

    Google Scholar 

  13. 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 12:62–925

    Article  PubMed  PubMed Central  Google Scholar 

  14. Böstman OM, Pihlajamäki HK (2000) Adverse tissue reactions to bioabsorbable fixation devices. Clin Orthop Relat Res® 371:216–227

    Article  Google Scholar 

  15. Adolfsson L, Lindau T, Arner M (2001) Acutrak screw fixation versus cast immobilisation for undisplaced scaphoid waist fractures. J Hand Surg Br 26:192–195

    Article  CAS  PubMed  Google Scholar 

  16. Rettig AC, Kollias SC (1996) Internal fixation of acute stable scaphoid fractures in the athlete. Am J Sports Med 24:182–186

    Article  CAS  PubMed  Google Scholar 

  17. Wozasek GE, Moser KD (1991) Percutaneous screw fixation for fractures of the scaphoid. J Bone Joint Surg Br 73:138–142

    Article  CAS  PubMed  Google Scholar 

  18. Pinder RM, Brkljac M, Rix L et al (2015) Treatment of scaphoid nonunion: a systematic review of the existing evidence. J Haand Surg Am 40:1797-1805.e3

    Article  Google Scholar 

  19. Könneker S, Krockenberger K, Pieh C, et al (2019) Comparison of SCAphoid fracture osteosynthesis by MAGnesium-based headless Herbert screws with titanium Herbert screws: protocol for the randomized controlled SCAMAG clinical trial. BMC Musculoskelet Disord 20:357–019

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Sören Könneker & Peter M. Vogt

  2. Praxis Dr. Schächinger, Straubinger Str. 24, 93055, Regensburg, Germany

    Ulrich Schächinger

  3. Department of Plastic Surgery and Hand Surgery, University Hospital Zürich, Rämistr. 100, 8091, Zurich, Switzerland

    Sören Könneker

Authors
  1. Sören Könneker
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  2. Ulrich Schächinger
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  3. Peter M. Vogt
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Corresponding author

Correspondence to Sören Könneker.

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Conflict of interests

The department of the first and last author received funding by Syntellix AG for conducting the multicenter trial SCAMAG from which this article is not part of, but the project is about the same medical product. The authors declared no other potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

Ethics approval was obtained from the local ethics committee of Hanover Medical School, Germany under approval number 8853_BO_K_2020. All patient data were processed anonymously.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Könneker, S., Schächinger, U. & Vogt, P.M. Magnesium-Based Compression Screws in Acute Scaphoid Fractures and Nonunions. World J Surg 47, 1129–1135 (2023). https://doi.org/10.1007/s00268-023-06937-2

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  • DOI: https://doi.org/10.1007/s00268-023-06937-2

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