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掌骨骨折采用可吸收板手术治疗的长期疗效:回顾性研究。

Long-term outcomes of metacarpal fractures surgically treated using bioabsorbable plates: a retrospective study.

机构信息

Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

出版信息

BMC Musculoskelet Disord. 2020 Dec 7;21(1):817. doi: 10.1186/s12891-020-03841-x.

Abstract

BACKGROUND

Implants made from bioabsorbable unsintered hydroxyapatite and poly-L-lactate composites (u-HA/PLLA) are widely used in the oral, maxillofacial, and orthopedic fields. This study assess the long-term (> 5 years) outcomes of patients with metacarpal fractures who were surgically treated using bioabsorbable plates and screws (Super-Fixsorb MX40 mesh; Teijin Medical Technology, Osaka, Japan).

METHODS

A retrospective analysis of six patients with eight metacarpal fractures treated with bioabsorbable plates was done. All patients were followed for more than 5 years post-surgery. The clinical outcomes were evaluated using Q-DASH scores and the grip strength (GS): opposite side ratio. The resorption status of implants was assessed on plain computed tomography (CT) scans at final follow-up appointments.

RESULTS

The mean age of the patients at the time of surgery was 29.5 years (16-54), and the median follow-up period was 81.8 months (68-101). All fractures united without displacement after an average of 3.5 months, and there were no implant specific complications associated with the use of absorbable plates. The mean grip strength ratio was 85.1% (56.8-104.5). The mean Q-DASH scores of 11.36 points (0-34.09) was good in all but two patients. We also observed that it took more than 8 years for the plates to be absorbed completely.

CONCLUSIONS

This study demonstrates that the process of bioabsorption in metacarpal fractures might be completed in about 8 years, and the absorption speeds were different inside and outside of the bone. The bioabsorbable plates are more cost-effective than metallic implants. The potential for bioabsorbable plates to be used in various clinical procedures is promising.

摘要

背景

由可吸收的未烧结羟基磷灰石和聚 L-乳酸复合材料(u-HA/PLLA)制成的植入物广泛应用于口腔、颌面和骨科领域。本研究评估了使用可吸收板和螺钉(Super-Fixsorb MX40 网;日本帝人医疗技术公司)治疗掌骨骨折患者的长期(>5 年)结果。

方法

对 6 例 8 处掌骨骨折患者使用可吸收板进行回顾性分析。所有患者术后随访时间均>5 年。使用 Q-DASH 评分和握力(GS):对侧比值评估临床结果。在最后一次随访时,通过平扫 CT 评估植入物的吸收情况。

结果

手术时患者的平均年龄为 29.5 岁(16-54 岁),中位随访时间为 81.8 个月(68-101 个月)。所有骨折在平均 3.5 个月后均无移位愈合,且无与使用可吸收板相关的特定植入物并发症。平均握力比为 85.1%(56.8-104.5)。11.36 分(0-34.09)的平均 Q-DASH 评分在除两名患者外的所有患者中均良好。我们还观察到,板的完全吸收需要超过 8 年的时间。

结论

本研究表明,掌骨骨折的生物吸收过程可能需要 8 年左右完成,并且骨内和骨外的吸收速度不同。可吸收板比金属植入物更具成本效益。可吸收板在各种临床操作中的应用潜力是有希望的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f416/7722336/2ac2d8b84d45/12891_2020_3841_Fig1_HTML.jpg

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