Egerci Omer Faruk, Dogruoz Fırat, Cetin Hakan, Ertan Mehmet Baris, Yapar Aliekber, Kose Ozkan
Department of Orthopedics and Traumatology, University of Health Sciences, Antalya Training and Research Hospital, Varlık mah., Kazım Karabekir cd, Muratpasa, Antalya, 07100, Turkey.
Medikum Private Hospital, Orthopedics and Traumatology Clinic, Antalya, Turkey.
J Orthop Surg Res. 2025 Mar 19;20(1):296. doi: 10.1186/s13018-025-05701-7.
This retrospective study aimed to evaluate the clinical and radiological outcomes of magnesium (Mg) bioabsorbable compression screws in the management of scaphoid fractures and nonunion. Despite theoretical benefits, such as osteoinductive properties and gradual degradation facilitating bone remodeling of these novel implants, clinical evidence on their efficacy remains limited.
A retrospective analysis was conducted on 20 patients who underwent scaphoid fracture or nonunion surgery with Mg screws at our hospital between 2015 and 2024. Patients with a minimum of 12 months of radiological follow-up were included. Functional assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) and Mayo Wrist Score, while radiographic outcomes focused on union, screw integrity, and cystic changes. Statistical analysis compared grip strength and wrist range of motion to the contralateral side.
The mean clinical follow-up period was 78.3 months (SD ± 22.0; range 14-108), and the mean radiological follow-up was 59.1 months (SD ± 30.5; range 12-99). Functional assessments showed a mean Q-DASH score of 11.5 (SD ± 16.9; range 0-68.2) and a Mayo Wrist Score of 75.7 (SD ± 13.3; range 45-95), indicating moderate functional recovery. The non-union rate was 40%, with complications including screw breakage in 25% of patients and cystic lesion formation around screws in most cases. No infections were reported. Wrist range of motion and grip strength were both significantly reduced on the injured side compared to the intact side.
Mg screws demonstrate potential benefits for bioabsorbable fixation, but our findings indicate a high rate of complications, including non-union and screw instability, in scaphoid fractures. The study suggests that Mg screws may not provide adequate stability for complex fractures in small bones like the scaphoid.
Level IV, retrospective cohort study.
本回顾性研究旨在评估镁（Mg）生物可吸收加压螺钉在舟骨骨折和骨不连治疗中的临床和影像学结果。尽管这些新型植入物具有诸如骨诱导特性和逐渐降解促进骨重塑等理论优势，但其疗效的临床证据仍然有限。
对2015年至2024年期间在我院接受使用镁螺钉的舟骨骨折或骨不连手术的20例患者进行回顾性分析。纳入至少有12个月影像学随访的患者。使用手臂、肩部和手部快速残疾评定量表（Q-DASH）和梅奥腕关节评分进行功能评估，而影像学结果重点关注骨愈合、螺钉完整性和囊性改变。统计分析将握力和腕关节活动范围与对侧进行比较。
平均临床随访期为78.3个月（标准差±22.0；范围14 - 108），平均影像学随访期为59.1个月（标准差±30.5；范围12 - 99）。功能评估显示平均Q-DASH评分为11.5（标准差±16.9；范围0 - 68.2），梅奥腕关节评分为75.7（标准差±13.3；范围45 - 95），表明功能恢复中等。骨不连率为40%，并发症包括25%的患者出现螺钉断裂，大多数情况下螺钉周围形成囊性病变。未报告感染情况。与健侧相比，患侧的腕关节活动范围和握力均显著降低。
镁螺钉在生物可吸收固定方面显示出潜在益处，但我们的研究结果表明，舟骨骨折的并发症发生率较高，包括骨不连和螺钉不稳定。该研究表明，镁螺钉可能无法为舟骨等小骨的复杂骨折提供足够的稳定性。
IV级，回顾性队列研究。
