Use of bioabsorbable pins in surgical fixation of comminuted periarticular fractures

Scott R. Bassuener, Brian Mullis, Ryan K. Harrison, Roy Sanders

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: To determine if bioabsorbable pins can be used for stabilization of comminuted articular fragments in periarticular fractures with adequate quality of fixation, while eliminating the potential complications related to use of traditional implants. DESIGN: Multicenter retrospective review. SETTING: Two Level 1 trauma centers. PATIENTS/PARTICIPANTS: Institutional billing records identified all cases (83) in which bioabsorbable pins were implanted. All charts were reviewed, and all periarticular fracture cases (80 fractures in 78 patients) were included. INTERVENTION: Open reduction and internal fixation of highly comminuted periarticular fractures, using bioabsorbable poly-p-dioxanone and poly-l-lactic acid pins to stabilize the fragments of articular surface. MAIN OUTCOME MEASUREMENTS: Outcomes were determined by maintenance of articular reduction assessed at 6 weeks and 3 months; development of posttraumatic arthritis assessed radiographically and by clinical examination at 1 year postoperatively; and rates of local complications including infection, pin migration, and pin-related soft tissue complications evaluated by complete medical record review. RESULTS: No patients showed loss of articular reduction at 6 weeks or 3 months. There were no pin-related local complications or pin migration and no instances of delayed union or nonunion. Radiographs showed 19% arthritic changes at 12 months, with 16% loss to follow-up. Infection rate was 6%. CONCLUSIONS: In highly comminuted periarticular fractures, bioabsorbable pins are an intriguing alternative to traditional fixation methods. They afford similar effectiveness in maintaining stability without evidence of pin migration or other concerns of buried metallic implants. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)607-610
Number of pages4
JournalJournal of Orthopaedic Trauma
Volume26
Issue number10
DOIs
StatePublished - Oct 2012

Fingerprint

Comminuted Fractures
Joints
Arthritis
Trauma Centers
Infection
Medical Records
Maintenance

Keywords

  • articular
  • bioabsorbable
  • infection
  • K-wire
  • Kirschner
  • periarticular
  • PGA
  • pins
  • PLLA
  • polyglycolic acid
  • polylactic acid
  • SR-PLLA
  • wire

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Use of bioabsorbable pins in surgical fixation of comminuted periarticular fractures. / Bassuener, Scott R.; Mullis, Brian; Harrison, Ryan K.; Sanders, Roy.

In: Journal of Orthopaedic Trauma, Vol. 26, No. 10, 10.2012, p. 607-610.

Research output: Contribution to journalArticle

Bassuener, Scott R. ; Mullis, Brian ; Harrison, Ryan K. ; Sanders, Roy. / Use of bioabsorbable pins in surgical fixation of comminuted periarticular fractures. In: Journal of Orthopaedic Trauma. 2012 ; Vol. 26, No. 10. pp. 607-610.
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abstract = "OBJECTIVES: To determine if bioabsorbable pins can be used for stabilization of comminuted articular fragments in periarticular fractures with adequate quality of fixation, while eliminating the potential complications related to use of traditional implants. DESIGN: Multicenter retrospective review. SETTING: Two Level 1 trauma centers. PATIENTS/PARTICIPANTS: Institutional billing records identified all cases (83) in which bioabsorbable pins were implanted. All charts were reviewed, and all periarticular fracture cases (80 fractures in 78 patients) were included. INTERVENTION: Open reduction and internal fixation of highly comminuted periarticular fractures, using bioabsorbable poly-p-dioxanone and poly-l-lactic acid pins to stabilize the fragments of articular surface. MAIN OUTCOME MEASUREMENTS: Outcomes were determined by maintenance of articular reduction assessed at 6 weeks and 3 months; development of posttraumatic arthritis assessed radiographically and by clinical examination at 1 year postoperatively; and rates of local complications including infection, pin migration, and pin-related soft tissue complications evaluated by complete medical record review. RESULTS: No patients showed loss of articular reduction at 6 weeks or 3 months. There were no pin-related local complications or pin migration and no instances of delayed union or nonunion. Radiographs showed 19{\%} arthritic changes at 12 months, with 16{\%} loss to follow-up. Infection rate was 6{\%}. CONCLUSIONS: In highly comminuted periarticular fractures, bioabsorbable pins are an intriguing alternative to traditional fixation methods. They afford similar effectiveness in maintaining stability without evidence of pin migration or other concerns of buried metallic implants. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.",
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AB - OBJECTIVES: To determine if bioabsorbable pins can be used for stabilization of comminuted articular fragments in periarticular fractures with adequate quality of fixation, while eliminating the potential complications related to use of traditional implants. DESIGN: Multicenter retrospective review. SETTING: Two Level 1 trauma centers. PATIENTS/PARTICIPANTS: Institutional billing records identified all cases (83) in which bioabsorbable pins were implanted. All charts were reviewed, and all periarticular fracture cases (80 fractures in 78 patients) were included. INTERVENTION: Open reduction and internal fixation of highly comminuted periarticular fractures, using bioabsorbable poly-p-dioxanone and poly-l-lactic acid pins to stabilize the fragments of articular surface. MAIN OUTCOME MEASUREMENTS: Outcomes were determined by maintenance of articular reduction assessed at 6 weeks and 3 months; development of posttraumatic arthritis assessed radiographically and by clinical examination at 1 year postoperatively; and rates of local complications including infection, pin migration, and pin-related soft tissue complications evaluated by complete medical record review. RESULTS: No patients showed loss of articular reduction at 6 weeks or 3 months. There were no pin-related local complications or pin migration and no instances of delayed union or nonunion. Radiographs showed 19% arthritic changes at 12 months, with 16% loss to follow-up. Infection rate was 6%. CONCLUSIONS: In highly comminuted periarticular fractures, bioabsorbable pins are an intriguing alternative to traditional fixation methods. They afford similar effectiveness in maintaining stability without evidence of pin migration or other concerns of buried metallic implants. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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