Bio-resorbable versus metal implants in wrist fractures: A randomised trial
ABSTRACT Distal radius fractures are often surgically treated if insufficient reduction has been achieved or after conservative treatment has failed. Treatment using metal implants often demands a secondary operation to remove the implant. A bio-resorbable implant (in this study the Reunite osteosynthesis plate by Biomet Inc) should obviate the need for a secondary operation with equal functional results.
Thirty-two patients with a distal radius fracture were assigned to treatment with either a bio-resorbable implant (N = 19) or a metal implant (N = 13). Both groups received the same postoperative care and were followed for 52 weeks in the outpatient clinic. The hypothesis of this study was a decrease in re-operation rate in the experimental group with equal functional results.
Five out of 19 patients treated with the Reunite plate were re-operated and four out of 13 treated with metal implants needed a secondary operation. In both implants, equal functional results in Range of Motion and DASH scores were found.
There were no significant differences between the experimental and control group with respect to re-operations, DASH scores and Range of Motion. Because of the higher initial costs and equal results, the use of bio-resorbable implants must be considered carefully.
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ABSTRACT: The occurrence of anomalous muscles in the hand is rare, and therefore the clinician frequently does not account for their existence when reaching the diagnosis and concluding the cause of carpal tunnel syndrome. This case report describes the highly unusual case of the occurrence of bilateral flexor digitorum superficialis muscles in a recreational climber who developed CTS following his intensive training schedule.Archives of Orthopaedic and Trauma Surgery 03/2009; 130(1):37-40. DOI:10.1007/s00402-009-0826-8 · 1.36 Impact Factor
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ABSTRACT: Volar plating is commonly used in the management of distal radius fractures; bioresorbable plates have attractive features. We compared a bioresorbable plate with a latest generation and an established locked titanium plate. Twenty-four fresh-frozen radii (12 pairs) were assigned to three mean bone mineral density-matched groups of eight radii each. A standardized extraarticular distal radius fracture was created and plated using one implant type per group. Postplating stiffness and displacement were studied in a first axial-loading test (15 cycles at 250 N). Next, biodegradation was simulated by 4 weeks' immersion in phosphate-buffered saline, followed by a second axial test. Finally, the specimens underwent cyclic loading (2,400 cycles at 250 N). It is clear from the initial test that the LCP plate was significantly stiffer and displaced less than the bioresorbable plate. The outcome of the postimmersion tests is that one bioresorbable plate failed early on after 4 weeks' immersion, and the remaining bioresorbable plates and the T plates did not differ significantly. Cyclic tests conclude that the LCP plate was significantly superior to the other systems. One T plate and four of the bioresorbable plates failed, but none of the LCP plates failed. In the bioresorbable constructs, stability, time to failure, and bone mineral density were significantly correlated. The LCP plate was biomechanically superior and may be generally recommended for the volar plating of distal radius fractures. Except one plate failure, the bioresorbable plate was similar to the T plate in the quasi-static tests and should, therefore, be considered for clinical studies, with patient selection confined, initially, only to candidates with good bone stock quality.The Journal of trauma 12/2009; 68(4):984-91. DOI:10.1097/TA.0b013e3181b28962 · 2.96 Impact Factor
- The Journal of Bone and Joint Surgery 11/2010; 92(16):2719-24. DOI:10.2106/JBJS.I.01761 · 4.31 Impact Factor