Comparative Study Between Osteosynthesis in Conventional and Bioabsorbable Implants in Ankle Fractures

Abstract

Objective: To compare the functional results of ankle fractures treated with metallic and absorbable plates. Twenty patients were randomized into two groups (metallic and absorbable implant groups) and followed prospectively. In the immediate postoperative period, patients were immobilized with plaster casts for one week, which was replaced by a removable cast for another four weeks. Partial weight-bearing was allowed after three weeks, and full weight-bearing after six weeks. Functional recovery was similar in both groups. At six months, three patients in the metallic group complained of local pain, and had their implants removed. One patient in the absorbable group exhibited early dehiscence of the suture and underwent debridement and suturing with good evolution. The American Orthopaedic Foot and Ankle Society (AOFAS) score was similar between the two groups after six and nine months of follow-up. The absorbable implants showed clinical and functional results that were similar to those of metallic implants. Level of Evidence II, Prospective Comparative Study.

Zastosowanie śrub biowchłanialnych w porównaniu ze śrubami metalowymi w truamatologii dziecięcej

“…Objectively in children this kind of trials would be difficult from ethical point, as the group with metal stabilizing devices would have to undergo a second surgery. Nevertheless in adults, in a recent study from 2015 Gaiarsa et al have confirmed similar clinical and functional results of use of bioabsorbable and metallic plates in the ankle fractures [30]. A recent meta-analysis of 4 studies regarding use of bioabsorbable and metallic screws in fixation of malleolar fractures with tibiofibular syndesmotic raptures in 280 adult patients showed no statistically significant difference in number of complications and range of motion [31].…”

Characteristics and Effectiveness of Postoperative Rehabilitation Strategies in Ankle Fractures: A Systematic Review

“…Of all studies, 40 23–61 described their postoperative rehabilitation strategy but did not evaluate effectiveness and 15 20–22,62–73 focused on evaluating the effectiveness of the postoperative rehabilitation strategy. This section reports only those 40 studies that described their postoperative rehabilitation strategy, focusing on weight-bearing, immobilization, and other therapy administered.…”

“…The studies categorized as early weight-bearing included an initial period of no weight-bearing, from 1 to 3 weeks, but most frequently 2 weeks, followed often by a period of partial weight-bearing from 2 to 6 weeks, before progressing to full weight-bearing (see Table, Supplemental Digital Content 3, http://links.lww.com/JOT/B766). [31][32][33][34][35][36][37][38][39][40][41]61 Progression to full weight-bearing was described inconsistently, with terms such as "gradual" without further clarification, 31,38 or not described at all. 37,41 In studies categorized as late weight-bearing, patients were advised to remain non-weight-bearing for up to at least 4 weeks, in most cases 6 weeks (see Table, Supplemental Digital Content 4, http://links.lww.com/JOT/B767).…”

“…In some studies, these devices were later replaced by removable casts, braces, or ankle stirrups to aid in weaning. 27,32,34,36,37,42,44 Wang et al 57 and Zhan et al 51 did not use any immobilization or devices, and 6 studies 24,28,29,50,59,60 did not report whether any devices were used by patients postoperatively.…”

Does the Inion OTPSTM absorbable plating system induce higher foreign-body reaction than titanium implants? An experimental randomized comparative study in rabbits

“…Inion OTPS TM Biodegradable Plating System is a third-generation bioabsorbable implant system consisting of carbon trimethylene, L-polylactic acid, and D, L-polylactic acid. However, there are conflicting reports in the literature regarding the occurrence and degree of tissue response after application of this implant type in bone fractures [8,13,15,16]. The aim of the current prospective randomized animal study was to compare the incidence of foreignbody reaction between Inion OTPS TM absorbable plates and conventional titanium plates considering clinical, laboratory, radiological and histological parameters.…”