Jukkala-Partio K, Partio E K, Helevirta P, Pohjonen T, Törmälä P, Rokkanen P
Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Ann Chir Gynaecol. 2000;89(1):45-52.
Cancellous bone fractures and arthrodeses have been treated successfully with bioabsorbable polyglycolide and poly-L-lactide implants. In this study bioabsorbable poly-L-lactide lag screws and metallic screws were compared in the fixation of subcapital femoral neck fractures.
Forty patients with femoral neck fractures were treated by internal fixation using three bioabsorbable self-reinforced poly-L-lactide (SR-PLLA) lag screws of 6.3 mm in diameter and 38 patients using three metallic screws of 7 mm in diameter. In addition, one patient was operated on using two and one using four metallic screws. The patients did not differ in age, body weight or primary dislocation of the fracture. There were six males in the lactide group versus 14 in the metallic fixation group. There were two Garden Stage I, 27 Garden Stage II, nine Garden Stage III, and two Garden Stage IV fractures in both groups.
In the Garden I and II fractures there were 5/29 redislocations after SR-PLLA fixation and 8/29 after metallic fixation. In the Garden III fractures there were 4/9 and in the Garden IV fractures 2/2 redislocations in both groups. The ability to walk and the range of movement were better after bioabsorbable fixation.
Self-reinforced poly-L-lactide lag screws can be used safely to fix subcapital femoral neck fractures in Garden Stage I and II fractures and in younger patients in Garden III fractures.
生物可吸收聚乙交酯和聚-L-丙交酯植入物已成功用于治疗松质骨骨折和关节融合术。本研究比较了生物可吸收聚-L-丙交酯拉力螺钉和金属螺钉在股骨颈基底部骨折固定中的效果。
40例股骨颈骨折患者采用3枚直径6.3mm的生物可吸收自增强聚-L-丙交酯（SR-PLLA）拉力螺钉进行内固定治疗，38例患者采用3枚直径7mm的金属螺钉进行治疗。此外，1例患者使用2枚金属螺钉进行手术，1例使用4枚金属螺钉。两组患者在年龄、体重或骨折初始移位情况方面无差异。丙交酯组有6例男性，金属固定组有14例男性。两组均有2例Garden I期、27例Garden II期、9例Garden III期和2例Garden IV期骨折。
在Garden I期和II期骨折中，SR-PLLA固定后有5/29例再移位，金属固定后有8/29例。在Garden III期骨折中，两组均有4/9例再移位，在Garden IV期骨折中有2/2例再移位。生物可吸收固定后患者的行走能力和活动范围更佳。
自增强聚-L-丙交酯拉力螺钉可安全用于固定Garden I期和II期股骨颈基底部骨折以及Garden III期骨折中的年轻患者。
