Hughes Thomas B
Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA.
Clin Orthop Relat Res. 2006 Apr;445:169-74. doi: 10.1097/01.blo.0000205884.81328.cc.
Bioabsorbable implants have been used extensively in medicine. Many have suggested interest in these materials for hand fractures since they may lead to less implant morbidity and subsequent stiffness, and they have additional advantages: they are radiolucent, they eliminate hardware removal procedures, they limit stress shielding, and they incrementally transfer load to healing fractures. Disadvantages include weakness relative to metal implants, rapid loss of initial implant strength, higher refracture rates, and foreign body reactions. Newer polymers have led to a reduction in these complications and more stable fixation. While not yet incorporated into the armamentarium of most surgeons, there is promise that in the near future they may assist in the management of some hand fractures.
Level V (expert opinion).
生物可吸收植入物已在医学中广泛应用。许多人对这些材料用于手部骨折感兴趣,因为它们可能导致较少的植入物并发症和随后的僵硬,并且它们还有其他优点:它们是射线可透过的,它们消除了取出内固定物的手术,它们限制了应力遮挡,并且它们逐渐将负荷转移至愈合的骨折部位。缺点包括相对于金属植入物强度较弱、初始植入物强度快速丧失、再骨折率较高以及异物反应。新型聚合物已减少了这些并发症并实现了更稳定的固定。虽然大多数外科医生尚未将其纳入常用器械中,但有望在不久的将来它们可协助管理某些手部骨折。
V级(专家意见)。