This is a prospective randomized study comparing the use of biodegradable polylactide pins with standard miniature fragmentary implants for the treatment of displaced radial head fractures. The authors followed 164 patients. At two years, 135 patients (82%) were available for evaluation. Patients underwent open reduction internal fixation with either 2 mm diameter polylactide pins or an AO miniature fragmentary plate. Post-operative protocol consisted of therapy for up to six weeks. Clinical and radiographic evaluations were done at six weeks, one year, and two years. Evaluation consisted of Broberg and Morrey scales.
The results indicate that 96% of the polylactide patients and 92% of those treated with standard plates had excellent or good results. There was no statistically significant difference between the groups. The authors did note that the number of fragments contributed to worse outcomes. Twenty-two (27%) of the plate-screw patients underwent hardware removal. The authors noted that seroma, fistula, or sinus formation was not observed in any patients. However, displacement occurred in five of the polylactide patients and two of the plate and screw patients.
This study suggests that degradable polylactide pins are a viable option for displaced radial head fractures. They clearly do not have the same necessity for implant removal when compared to traditional hardware. In addition, the previous complications noted with resorbable implants, such as foreign body reaction and osteolysis, were not seen when used for this indication. Stability of fixation, however, may be less than that compared with traditional implants. This is especially true when one considers the newer locking plate technology that is currently available for radial head and neck fractures.
Radial, Head, Fracture, Biodegradable, Resorbable, Implants
J Shoulder Elbow Surgery