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Broches et vis biorésorbables: une nouvelle méthode de fixation des fractures de l'olécrâne

Absorbable rods and screws: a new method of fixation for fractures of the olecranon

Etude clinique prospective sur 41 malades

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Summary

Between April 1986 and July 1990 fractures of the olecranon in 41 adult patients were treated by fixation with absorbable rods (20 patients) and screws (21 patients) of self-reinforced polyglycolide (SR-PGA), 3.2 mm in diameter and 20–70 mm in length. Patients were followed up for a mean time of 2 years 7 months (range 1 year to 4 years 6 months). After reduction of the fracture, channels were drilled from the proximal fragment through the cortex of the distal fragment and the fractures were fixed with absorbable rods or screws. By one year from follow-up maintenance of an anatomical reduction of the fracture was seen in 34 patients. Failure of fixation requiring a second operation occured in 2 cases. In all cases functional recovery was at least satisfactory. Sinus formation as a sign of transient tissue reaction was observed in 3 cases, but did not influence the healing of the fractures or the functional recovery. The results in patients treated with rods or screws was similar. Absorbable screws combined with small rods and absorbable sutures allow treatment of +ore severe fractures of the olecranon than do rods alone.

Résumé

Quarante et un malades présentant une fracture de l'olécrâne ont été traités au moyen de broches et vis biorésorbables. Onze fractures étaient comminutives. Les broches ont été utilisées chez 20 malades (groupe 1) et les vis chez 21 malades (groupe 2). Les résultats radiologiques ont été bons dans 34 cas (83%), moyens dans 5 cas (léger déplacement de la fracture ou légère incongruence articulaire), et mauvais dans 2 cas nécessitant une ré-intervention (ostéosynthèse défaillante dans un cas et fragment déplacé dans un autre cas). Il y a eu 4 retards de consolidation. A un an, les résultats fonctionnels ont été au moins satisfaisants dans 39 cas (95%), Il n'y a pas eu de différence significative dans les résultats entre les deux groupes. Cette étude montre que les broches et les vis biorésorbables sont un matériau fiable dans la fixation des fractures de l'olécrâne. Leur avantage par rapport aux matériaux métalliques conventionnels est qu'ils évitent la réintervention pour retirer le matériel d'ostéosynthèse.

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Authors and Affiliations

  1. Clinique d'Orthopédie et de Traumatologie, Centre Hospitalier Universitaire d'Helsinki, SF - 00260, Helsinki, Finlande

    E. K. Partio, E. Hirvensalo, O. Böstman, H. Pätiälä, S. Vainionpää,  Vitonen & P. Rokkanen

  2. Laboratoire des Biomatériaux, Ecole Technique Supérieure, SF - 33101, Tampere, Finlande

    P. Helevirta & P. Törmälä

Authors
  1. E. K. Partio
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  2. E. Hirvensalo
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  3. O. Böstman
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  4. H. Pätiälä
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  5. S. Vainionpää
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  6. Vitonen
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  7. P. Helevirta
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  8. P. Törmälä
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  9. P. Rokkanen
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Partio, E.K., Hirvensalo, E., Böstman, O. et al. Broches et vis biorésorbables: une nouvelle méthode de fixation des fractures de l'olécrâne. International Orthopaedics 16, 250–254 (1992). https://doi.org/10.1007/BF00182705

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