Osteolytic changes accompanying degradation of absorbable fracture fixation implants

J Bone Joint Surg Br. 1991 Jul;73(4):679-82. doi: 10.1302/0301-620X.73B4.1649195.

Abstract

We analysed the radiographs of 67 patients with displaced malleolar fractures treated by open reduction and internal fixation using absorbable polyglycolide rods. Seventeen patients developed a discharging inflammatory foreign-body reaction, a complication unique to these fixation devices. In 34 patients ovoid osteolytic foci, usually 5 to 10 mm in diameter, appeared within the implant channels six to 12 weeks after the operation. The same lesion occurred in 14 of the 17 patients who developed a foreign-body reaction, whereas only 20 out of the 50 patients with an uneventful course showed osteolytic areas (p less than 0.01). In patients with a foreign-body reaction the osteolytic foci tended to occur in the deepest parts of the implant channels. However, after one year the normal structure of the bone was restored.

MeSH terms

  • Adult
  • Ankle Injuries*
  • Biodegradation, Environmental
  • Fibula / injuries*
  • Follow-Up Studies
  • Foreign-Body Reaction / diagnostic imaging
  • Foreign-Body Reaction / etiology*
  • Foreign-Body Reaction / physiopathology
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Fractures, Bone / surgery*
  • Humans
  • Osteolysis*
  • Polyglycolic Acid / adverse effects*
  • Polymers / adverse effects*
  • Prostheses and Implants / standards*
  • Radiography
  • Tibial Fractures / surgery*

Substances

  • Polymers
  • Polyglycolic Acid