THE RESULTS OF OPEN REDUCTION- BONE GRAFTING AND INTERNAL FIXATION WITH BIODEGRADABLE IMPLANTS IN THE TREATMENT OF SCAPHOID PSEUDOARTHROSIS

Abstract

Indroduction: To present our clinical experience in patients with scaphoid pseudoarthrosis treated by internal fixation with biodegradable implants.
Patients and methods: Between April 1993- February 1997 twelve male patients with scaphoid pseudoarthrosis were treated by open reduction and internal fixation with biodegradable implants.They were evaluated in respect to pain, range of motion, grip strength and satisfaction. The mean age of the patients was 22.5 years. According to Herbert classification; ten patients had type D2 scaphoid pseudoarthrosis with fracture line in the middle 1/3, one patient had type D2 scaphoid pseudoarthrosis with a fracture line in the proximal 1/3 and one patient had type D1 scaphoid distal 1/3 fibrous union. Preoperative mean wrist flexion, extension, radial deviation and ulnar deviation were 44.5°, 41.6°, 10.4°, 10.8° respectively. According to the Modified Mayo wrist scoring system (MMWSS), mean score was 22,08 preoperatively.
Results: The mean solid union time was 4.5 months. At the end of the 12th month, the mean MMWSS score was 80,8. We obtained excellent result in 6 patients, good result in 2 patients, fair result in 2 patient and poor result in 1 patient.
Discussion: There is a trend to use of biodegradable material in orthopaedic surgery because of the favorable clinical results that have been obtained. The results of tis study are similar to those, obtained in the other studies using metallic fixation materials for the treatment of scaphoid pseudoarthrosis. The major advantage of biodegradable materials is to exclude the requirement for second operation to remove the fixation material.