Internal fixation of unstable radial head fracture: A comparison of metallic and biodegradable implants

Young Hak Roh, Sangwoo Kim, Hyun Sik Gong, Goo Hyun Baek

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Biodegradable implants for internal fixation of radius head fractures may overcome some disadvantages of metallic implants for internal fixation, such as metallosis, osteopenic change caused by a stress shielding effect, and the potential need for a removal surgery. The purpose of this study was to evaluate the outcomes of the fixation of radial head fractures with biodegradable pins compared to those with metallic implants. Methods: Eighty-four patients who had been diagnosed with unstable radial head fracture and who were scheduled to undergo surgical fixation were randomized into two groups, with one undergoing surgery with metallic implants and the other undergoing surgery with biodegradable implants. Clinical outcomes were assessed through the total range of motion of the elbow joint; the Disability of the Arm, Shoulder, and Hand (DASH) score; and the Mayo Elbow Performance Score (MEPS) at three and 12 months after surgery. Radiographic results were assessed using the criteria of the Broberg and Morrey classification and time to bone union. Results: The DASH scores at three months of follow-up were significantly better in the metallic group, but there were no significant differences in the MEPS score at three and 12 months, or in the DASH score at 12 months between the two groups. Patients in the biodegradable group had a longer mean time to bone union than those in the metallic group (14 vs. 12 weeks). Five (12%) subjects in the metallic group underwent hardware removal surgery. At a mean of 19.7 months, there were no differences in the degree of traumatic arthritis between the groups. Conclusion: The outcomes of the use of biodegradable implants for isolated radial head fractures were comparable to those of metallic implants along with a longer average time to fracture union for biodegradable implants.

Original languageEnglish
JournalInjury
DOIs
StateAccepted/In press - 2019

Keywords

  • Biodegradable implants
  • Internal fixation
  • Metallic implants
  • Outcomes
  • Radial head fractures

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