Application of absorbable screws in intra-articular fractures

Journal of Nanjing Medical University, Beijing, China. Application of absorbable screws in intra-articular fractures Luo Dongshan Wang Bin Xiong Jin Wu Wu Zhu Lihua Department of Orthopaedics, Nanjing Gulou Hospital, Nanjing For more than a decade, scientists from all over the world have been working on absorbable materials in 1984. For the first time, the absorbable material was successfully applied, and the ankle fracture was fixed. Our hospital since May 1996, 1999. 51. With its own enhanced polypropylene fat to heart, 1.1 absorb snail. 1 18 cases of intra-articular fractures were treated with satisfactory results. The report is as follows.

1 Materials and Methods In this group of 18 patients, 12 males and 6 females; aged 652 years, mean 31.8 years old. There were 1 case of humeral head fracture in the fracture site, 2 cases of external humerus fracture, 1 case of humeral head fracture, 2 cases of hip fracture, 5 cases of femoral head fracture, 3 cases of femoral neck fracture and 3 cases of humeral intercondylar fracture. 4 cases of ankle fracture. There were 2 cases of concussion, 1 case of intracranial hematoma, 1 case of humeral shaft fracture, 1 case of ulnar and radial fracture, and 2 cases of multiple metacarpal fracture. There were 17 fresh fractures and 1 old fracture, and the injury time was 322 days.

12 materials selected Finnish 610 company's internal fixation materials are divided into absorbable screws and 4.5, length 2570 surgical tools for the special screwdriver tap screw screw head horn ridge to help this group, the absorption screw, a total of 22 times.

1.3 surgical method for the femoral head fracture as an example of the posterior approach of the hip joint, the femoral head was removed during the operation, the free bone fragments in the joint were removed, the femoral skull block was first fixed and fixed, drilled with 2.7 drill bits, measured and used, and reused 3.51 tap tapping 3. The hoe is expanded into the hole, take the diameter 3.5, length 314, 1 absorbable screw screwed into the borehole, embed the tail of the nail into the cartilage, flush the joint cavity, and pull the femoral head under the traction Combined with acetabular fractures, depending on the condition of the femoral head and the size of the bone, the corresponding measures were taken to infuse the negative pressure drainage. The skin traction of the affected limbs was performed within 3 months. The results were followed up for 36 times. Month, an average of 15 months. All fractures healed, femoral head fracture combined with femoral neck fracture, and no avascular necrosis of the femoral head may be related to short time. Two cases of femoral neck fracture have healed and one is still in follow-up.

No incision infection and effusion, joint function returned to normal.

3 Discussion 8 people are not transparent. It has good tissue boundary and no toxic reaction. It can be hydrolyzed into glycolic acid and lactic acid in human tissues, and finally degraded into carbon oxide and hydraulic test. The initial bending strength of 0 is 25350,3, shearing. The strength is 170,220 cubits, 3, the initial strength value is about 2030 times the cancellous bone strength! Therefore, there is enough strength to make it securely fast. , in terms of. The complete absorption of 0. is about 24 years.

Under normal circumstances, it is advisable to use absorbable snails for intra-articular fractures. If the fixation needs to pass through the tarsal plate, a fixed rod should be used to avoid damage to the cartilage. The excess part of the fixture must be sawn with a chainsaw or a wire saw. Avoid using scissors or rongeurs. Otherwise, the rods are prone to splitting. 21 Because the anti-twisting force of the absorbable screws is smaller than that of the metal, care must be taken during implantation. Use too much torque, otherwise the screw will break. 31 Precautions Fix after fracture reduction, accurately drill, tapping into the contralateral cortex or suitable depth. There was no screw fracture in this group. There were 3 cases of severe trauma in this group. Except for femoral head fracture, combined with femoral neck fracture, the femoral head fracture was firstly restored during operation. The screw can be fixed by absorption screw. Then the femur can be removed. The head and neck were repositioned and fixed with 3 sigma needles. The three patients were 343,543 years old because of their youngness. Therefore, it was decided to cut open and reset the internal fixation first. The advantage of not using the artificial joint replacement rice to absorb the internal fixation is that Easy to operate, easy to master Although expensive, but eliminating the first surgery 4 to reduce the chance of infection, especially suitable for children with intra-articular fractures, to avoid delays in learning due to re-operation.

In the early stage of surgery, due to the temporary tissue reaction, there will be liquid accumulation around the implant, which is relatively small and painless, and is absorbed by itself. If there is more liquid, it can be pumped. This phenomenon has not been observed yet. The material is not suitable for load bearing 1 Huang Hong, Zhou Yongnian, Cai Fujin, etc. Clinical application of absorbable internal fixation materials. Jiangsu 2 Gu Xiaohua, Yin Xinqi. The application of absorbable internal fixation in intra-articular fractures. Bone and off fjti, fjㄇ1997, 12634S 3 Wu Yonggang, Baoyin, Zhao Lianbin. Absorbable screws for the treatment of intercondylar humeral fractures. Journal of Bone and Joint Injury, 1997, 126349 4 Liu Yonghui, Zhao Jinfu, Wei Wei, et al. Absorbable internal fixation for the treatment of intra-articular fractures.

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