Talocrural arthrodesis with absorbable screws

Partio, Esa K.; Hirvensalo, Eero; Partio, Esko; Pelttari, Seppo; Jukkala-Partio, Kirsi; Böstman, O; Hänninen, Antero; Törmälä, Pertti; Rokkanen, P

doi:10.3109/17453679209154816

Cited by 36 publications

(12 citation statements)

References 4 publications

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“…The use of biodegradable implants increases gradually as orthopedic surgery also increases gradually, and the results are equally successful as with metallic materials [4,7,11]. Although the number of cases in our study was small, the preliminary results were promising.…”

Section: Discussionmentioning

confidence: 60%

“…Partio et al reported successful results in 11 of 12 patients using SR-PGA and SR-PLLA screws in talocrural arthrodesis. The average union time was 9 weeks [11]. Partio also treated seven patients with severe hind foot valgus deformity due to spastic neuromuscular disease by subtalar arthrodesis [12].…”

Section: Discussionmentioning

confidence: 99%

“…Nine patients had a fall on outstretched hand, two patients injured the hand in a motor vehicle accident, and one patient was struck by a heavy object. The average time between fracture and surgery was 9.8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) months. In nine patients, the fracture was undiagnosed at the first visit, and three patients were treated unsuccessfully with a short spica cast.…”

Section: Methodsmentioning

confidence: 99%

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Biodegradable implants in the treatment of scaphoid nonunions

Akmaz¹,

Kiral

Pehlivan

et al. 2004

International Orthopaedics (SICOT)

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We reviewed 12 male patients with scaphoid nonunions treated by open reduction, bone grafting, and internal fixation with biodegradable implants made of selfreinforced poly-L-lactic acid. Mean patient age was 22.5 (20-25) years. Ten patients had type D2 scaphoid nonunions with a fracture line in the middle one third, one patient had type D2 nonunion with a fracture line in the proximal one third, and one patient had type D1 distal one-third fibrous union. The mean wrist score (modified Mayo wrist score) was 20.8 (10-40) preoperatively and improved after 22-80 months (55-90). All nonunions healed, and the mean solid union time was 4.5 (3.5-7) months. We obtained excellent results in five patients, good results in four, fair results in two, and a poor result in one. The results of this study offer a valid alternative in the fixation of scaphoid nonunions. The major advantage of biodegradable materials is to eliminate the requirement for the removal of the fixation material.Résumé Nous avons examiné douze malades de sexe masculin avec une non-consolidation du scaphoïde traitée par réduction ouverte, greffe osseuse et fixation interne avec des implants biodégradables faits d'acide poly-Llactique auto-renforcé (SR-PLLA). L'âge moyen des malades était de 22.5 ans (20)(21)(22)(23)(24)(25). Dix malades avaient une non-consolidation de type D2 avec le trait de fracture dans le tiers central, un malade avait le type D2 avec un trait de fracture dans le tiers proximal et un malade avait le type distal D1 avec union fibreuse. Le score moyen du poignet (Mayo wrist score modifié) était 20.8 (10-40) en préopératoire et amélioré après 22 mois à 80 (55-90). Toutes les nonunions ont consolidées dans un temps moyen de 4.5 mois (3.5-7). Nous avons obtenu d'excellents résultats chez cinq malades, de bons résultats chez quatre, des résultats médiocres chez deux et un résultat mauvais pour une. Les résultats de cette étude offrent une alternative valide pour la fixation des non-consolidations du scaphoïde. L'avantage majeur des matières biodégrad-ables est d'éliminer l'exigence d'ablation du matériel d'ostéosynthèse.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Biodegradable implants in the treatment of scaphoid nonunions

Akmaz¹,

Kiral

Pehlivan

et al. 2004

International Orthopaedics (SICOT)

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“…Hence, PLA has been clinically used in orthopedic and/or oral-maxillofacial surgeries (Bessho et al, 1997, Böstman et al, 1990, Partio et al, 1992a, 1992bSuuronen, 1993, Yamamuro et al, 1994 mechanical properties of PLA have not fulfilled the requirements of an application to a higher loaded part (Manninen et al, 1992, Shetty et al, 1997, Wittenberg et al, 1991. Therefore, self-reinforced (SR) PLA has been investigated to improve mechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Effects of initial crystallinity and molecular orientation on hydrolysis and mechanical properties of self-reinforced poly(lactic acid) screws

Sakaguchi

Kobayashi

2016

Mechanical Engineering Journal

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Poly(lactic acid) (PLA) attracts much attention as a typical biodegradable and biocompatible polymer, because it degrades to nontoxic lactic acid through non-enzymatic hydrolytic degradation. Processing of PLA bone fixation devices have been investigated to improve their mechanical properties. Among fixations, screws are referred as one of the most general bone fixation device. The purpose of the present study is to clarify the effect of initial higher-order structure on degradation behavior and associated mechanical properties for self-reinforced PLA screws. PLA screws were prepared through a series of routes including casting extrusion drawing and forging. These screws were immersed in phosphate buffer solution (PBS) for 0, 8, 16 and 24 weeks, and orientation function, crystallinity, molecular weight and shear strength were measured. As a result, initial shear strength increased and degradation ratio decreased with orientation. This is due to lower water absorption caused by orientation crystallization. Shear strength decreased approximately 15 % at least with 24 weeks immersion. The results of the crystallinity showed that the screws were selectively hydrolyzed in amorphous region. This fact suggested that shear strength retention depends on hydrolysis in amorphous region. Initial shear strength for extrusion ratio (ER) 2 is the highest although the orientation function is the lowest. And the strength rapidly decreased with 8 weeks immersion. This might be due to hydrolysis of oriented tie chains. Although  crystals emerged only at ER 4, there was not clear difference in molecular weights and shear strength. This result suggested that the crystal form has little effects on degradation behavior and mechanical properties.

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“…Since 1988, SR-PLLA implants have been in clinical use in orthopedics and traumatology, with favorable results in several indications such as ®xation of cancellous bone fractures and osteotomies in hallux valgus operations, repair of osteochondral and meniscal lesions of the knee, and in shoulder dislocation operations [9]. Two studies have been published on bioabsorbable ®xation in talocrural and triple arthrodeses of patients with rheumatoid arthritis: in 1992, Partio and associates performed three talocrural arthrodeses [10] and in 1995 Juutilainen and PaÈ tiaÈ laÈ did six talocrural and 11 triple arthrodeses using SR-PLLA screws or rods as ®xation devices [11].…”

Section: Introductionmentioning

confidence: 99%

Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

et al. 2001

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Self-reinforcing polylevolactic acid (SR-PLLA) implants have been used in arthrodeses of patients with rheumatoid arthritis. No long-term evaluation has been published so far. Two patients (three ankles) with destruction of the ankle joint and seven with destruction of the subtalar joint received ten arthrodeses. One out of three ankle arthrodeses healed and nonunion developed in two. Five out of seven triple arthrodeses attained bony union. Two patients with malunion of the subtalar and talonavicular joints are free of symptoms and need no reoperation. One superficial wound infection healed by oral antibiotics. In one patient, an ankle arthrodesis was performed 6 years after the triple arthrodesis of the left foot. SR-PLLA implants can be used in triple arthrodesis in rheumatoid arthritic patients with good results comparable to those of other studies. The problems with nonunion of ankle arthrodeses noticed in former studies are also attributable to this fixation method.

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Talocrural arthrodesis with absorbable screws

Cited by 36 publications

References 4 publications

Biodegradable implants in the treatment of scaphoid nonunions

Biodegradable implants in the treatment of scaphoid nonunions

Effects of initial crystallinity and molecular orientation on hydrolysis and mechanical properties of self-reinforced poly(lactic acid) screws

Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

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