Abstract
BackgroundScaphoid fractures account for 60–70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging. MethodsA systematic search of databases including PubMed, Ovid Medline, and Google Scholar databases was made to identify studies related to the use of bioabsorbable materials in scaphoid fixation and postoperative patient outcomes. PRISMA guidelines were utilised for this review. FindingsInitial search results yielded 852 studies. 124 studies were screened, with 79 patients across 7 studies included in this review. Poly-L-Lactic acid derivatives were the most common biomaterial for scaphoid fixation, with magnesium and polyglycolide also used. Levels of evidence for studies ranged between III-IV. Analysis demonstrated mixed findings with generally comparable outcomes to conventional alloy-based screws. InterpretationDevelopment in bioabsorbable materials is ongoing, however there remains a dearth in data regarding their use in the scaphoid. Further research is needed to establish the efficacy and applicability of bioabsorbable devices in the scaphoid bone.
Highlights
The scaphoid is the most commonly fractured carpal bone, ac counting for 60–70% cases of carpal injuries (Tysver and Jawa, 2010)
While good outcomes have been reported with cast immobilisation for minimally displaced scaphoids (Buijze et al, 2014), displaced fractures benefit from immediate surgical reduction (Dias et al, 2020)
Wichelhaus et al (Wichelhaus et al, 2016) described two magnesium-based screws inserted as secondary fixation, with Ek and Wang (Ek and Wang, 2017) using a polylactic acid (PLA) copolymer for fixation
Summary
The scaphoid is the most commonly fractured carpal bone, ac counting for 60–70% cases of carpal injuries (Tysver and Jawa, 2010). Recent developments in technology and complications arising from conventionally used metallic screws in orthopaedic fracture fixation including stress shielding (Haase and Rouhi, 2013), need for revision surgeries for removal of hardware (Brown et al, 2017), suboptimal radiological imaging due to artifact (Zhao et al, 2016) has led to research into other potentially useful methods of fixation. Recent tech nological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging. Methods: A systematic search of databases including PubMed, Ovid Medline, and Google Scholar databases was made to identify studies related to the use of bioabsorbable materials in scaphoid fixation and postoperative patient outcomes. Further research is needed to establish the efficacy and applicability of bioabsorbable devices in the scaphoid bone
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