Kapoutsis Dimitrios, Kitridis Dimitrios, Sachinis Nikolaos Platon, Ploumis Avraam, Givissis Panagiotis
Department of Orthopaedics, 424 Army General Training Hospital, Thessaloniki, Greece.
Department of Orthopaedics, George Papanikolaou Hospital, Aristotle University of Thessaloniki, Greece.
J Orthop Case Rep. 2020 Jul;10(4):49-53. doi: 10.13107/jocr.2020.v10.i04.1798.
Absorbable materials have been used as fixation devices in orthopaedic surgery. However, their use for treating isolated ulnar diaphyseal fractures in adults has not yet been studied. The aim of this study was to assess whether Inion OTPS™ absorbable implants consisting of L-lactide, D, L-lactide, and trimethylene carbonate provide adequate fixation for the healing of isolated ulnar diaphyseal fractures, their complication rate, and the patients' clinical functional outcome.
Three consecutive patients (all women; mean age, 45 years, and range 38-55 years) with isolated, unstable ulnar fractures were enrolled and treated operatively using Inion OTPS™ absorbable plates and screws. Discontinuation of the study was decided because of the early failure of all implants. The patients were assessed clinically (DASH Score and grip strength) and radiographically at 6 weeks, 3 months, 6 months, and 9 months. The incidence of late foreign body reactions was evaluated for 10 years follow-up period.
Implant failure was noticed radiographically in the early post-operative period in all three patients. Subsequently, one patient was treated operatively using metallic devices, and the other two with prolonged splinting. All fractures healed uneventfully in variable time frames. No foreign body reactions were noticed during and beyond the degradation period, other than a small painless mass in one case.
The results of the current study suggest that the Inion OTPS™ plating system is not appropriate for the fixation of isolated unstable ulnar diaphyseal fractures. It seems that these specific implants cannot withstand the internal mechanical forces of this anatomical area despite the protective splinting.
可吸收材料已被用作骨科手术中的固定装置。然而,其在治疗成人孤立性尺骨干骨折中的应用尚未得到研究。本研究的目的是评估由L-丙交酯、D,L-丙交酯和碳酸三亚甲基酯组成的Inion OTPS™可吸收植入物是否能为孤立性尺骨干骨折的愈合提供足够的固定,其并发症发生率以及患者的临床功能结局。
连续纳入3例患有孤立性、不稳定尺骨骨折的患者(均为女性;平均年龄45岁,范围38 - 55岁),并使用Inion OTPS™可吸收钢板和螺钉进行手术治疗。由于所有植入物均早期失效,决定终止研究。在术后6周、3个月、6个月和9个月对患者进行临床评估(DASH评分和握力)及影像学评估。对10年随访期内迟发性异物反应的发生率进行评估。
所有3例患者在术后早期影像学检查中均发现植入物失效。随后,1例患者使用金属器械进行手术治疗,另外2例采用延长夹板固定。所有骨折均在不同时间内顺利愈合。除1例出现一个小的无痛性肿块外,在降解期及之后均未发现异物反应。
本研究结果表明,Inion OTPS™钢板系统不适用于固定孤立性不稳定尺骨干骨折。尽管有保护性夹板固定,但这些特定的植入物似乎无法承受该解剖区域的内部机械力。