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An Improved Mechanical Testing Method to Assess Bone-implant Anchorage
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Preliminary experience with biodegradable implants for fracture fixation.

Mandeep S Dhillon1, Sharad Prabhakar, Chandiralingam Prasanna

  • 1Department of Orthopedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India. drdhillon@gmail.com

Indian Journal of Orthopaedics
|September 16, 2009
PubMed
Summary

Biodegradable implants show promise for specific fractures but have limitations in long bone applications. Surgeon confidence remains a concern due to perceived mechanical inferiority compared to traditional metal implants.

Keywords:
Biodegradable implantsfracturessurgeon confidence

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science

Background:

  • Biodegradable implants offer an alternative to metal fixation devices.
  • Surgeon skepticism in India regarding mechanical strength of biodegradable implants necessitates further investigation.

Purpose of the Study:

  • To assess the feasibility and surgeon confidence with biodegradable implants in an Indian orthopedic setting.
  • Evaluate the performance of biodegradable implants in various fracture types over a 12-month period.

Main Methods:

  • Prospective study involving 15 fractures treated with biodegradable implants.
  • Randomized surgical scheduling to involve surgeons of varying experience levels.
  • Inclusion of intra-articular, metaphyseal, and small bone fractures.

Main Results:

  • All fractures achieved union, though two cases experienced partial displacement during healing.
  • Additional K-wire fixation was required for three fractures (humeral condyle, capitulum).
  • External fixators were used in conjunction with bio-pins for two distal radius and two pilon fractures.

Conclusions:

  • Biodegradable implants are suitable for carefully selected intra-articular and small bone fractures.
  • Limitations persist for long bone fracture applications, with no significant advantage in hybrid composites.
  • Perceived lower mechanical strength compared to metal implants contributes to surgeon hesitancy, suggesting use in low-stress fracture patterns.