Foreign-body reactions to polyglycolide screws. Observations in 24/216 malleolar fracture cases

Out of 216 patients with displaced malleolar fractures operated on using absorbable polyglycolide screws, 24 developed a transient local nonbacterial inflammatory reaction on an average 3 months after the operation. Upon histopathologic examination, these tissue responses were found to be nonspecific foreign-body reactions. Neither the age of the patient nor the number of screws used in the fixation affected the incidence of the reactions. The first-generation screws that were colored with an aromatic quinone dye showed a higher incidence, 19 reactions among 105 patients, than the new noncolored implants, 5 among 111 patients (P less than 0.01). No deleterious effect of these tissue responses on the union of the fractures could be detected, but the possible long-term consequences of this complication are so far unknown.