Osteosynthesis and Trauma Care 2002; 10(1): 47-49
DOI: 10.1055/s-2002-30634
Original Articles

© Georg Thieme Verlag Stuttgart · New York

Failure Types of Bioabsorbable Fixation

A Classification SystemS. B. Antekeier, D. Seligson, C. Khalily
  • Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
Further Information

Publication History

Publication Date:
17 May 2002 (online)

Abstract

Bioabsorbable implants are becoming more widely used in fracture fixation. Like metallic implants, bioabsorbable fixation devices are subject to failures such as infection, but they also have their own inherent failure types. Unlike metallic implants, bioabsorbable implants are radiolucent, making the determination of correct placement difficult. Each type of bioabsorbable material has its own degradation rate, which influences the formation of a granuloma or sterile sinus tract. Additionally, the in vivo time to complete absorbtion has yet to be determined for several types of bioabsorbable implants. As the uses of bioabsorbable fracture fixation expand, a classification system of failure types will provide a useful framework with which to compare new outcomes.
Our study examines 346 patients who underwent fracture fixation with bioabsorbable implants. Through a retrospective analysis of patient records, four distinct failure types emerged:Type I - Iatrogenic Failure, Type II - Mechanical Failure, Type III - Biologic Failure, Type IV - Infection. Categorizing the failures under this classification system facilitates discussion about success and failure with these new fixation devices.

References

  • 1 Athanasiou K A, Agrawal C M, Barber F A, Burkhart S S. Orthopaedic applications for PLA-PGA biodegradable polymers.  Arthroscopy. 1998;  14 726-737
  • 2 Böstman O M, Pihlajmaki H K, Partio E K, Rokkanen P U. Clinical biocompatibility and degradation of polylevolactide screws in the ankle.  Clin Orthop. 1995;  320 101-109
  • 3 Böstman O M, Pihlajmaki H K. Adverse tissue reactions to bioabsorbable fixation devices.  Clin Orthop. 2000;  371 216-227
  • 4 Böstman O M, Pihlajmaki H K. Late foreign-body reaction to an intraosseous bioabsorbable polylactic acid screw: A case report.  J Bone Joint Surg [Am]. 1998;  80 1791-1794
  • 5 George K, Becker D, Seligson D. Absorbable fasteners for the fixation of ankle fractures.  J Kentucky Med Assoc. 1999;  97 105-108
  • 6 Kankare J. Operative treatment of displaced intra-articular fractures of the calcaneus using absorbable internal fixation: A prospective study of twenty-five fractures.  J Orthop Trauma. 1998;  12 413-419
  • 7 Nakamura S, Takatori Y, Morimoto S. et al . Rotational acetabular osteotomy using biodegradable internal fixation.  Int Orthop. 1999;  23 148-149
  • 8 Rokkanen P, Bostman O, Vainionpaa S. et al . Absorbable devices in the fixation of fractures.  J Trauma Inj Infect & Crit Care. 1996;  40 S123-127
  • 9 Suuronen R, Puhjonen T, Hietanen J, Lindqvist C. A 5-year in vitro and in vivo study of the biodegradation of polylactide plates.  J Oral Maxillofac Surg. 1998;  56 604-614
  • 10 Veikko V V, Lindholm T S. Background of the early development of absorbable fixation devices.  Techniques in Orthop. 1998;  13 117-122
  • 11 Weiler A, Hoffmann R FG, Stahelin A C, Helling H J, Sudkamp N P. Biodegradable implants in sports medicine: The biological base.  Arthroscopy. 2000;  16 305-321
  • 12 Weiler A, Helling H J, Kirch U, Zirbes T K, Rehm K E. Foreign-body reaction and the course of osteolysis after polyglycolide implants for fracture fixation: Experimental study in sheep.  J Bone Joint Surg [Br]. 1996;  78 369-376

Shannon B. AntekeierM.D. 

Department of Orthopaedic Surgery

University of Louisville School of Medicine

530 S. Jackson St

Louisville, KY 40202

USA

Phone: +1-502-852-6902

Fax: +1-502-852-7227

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