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Use of bioabsorbable pins in surgical fixation of comminuted periarticular fractures
Scott R Bassuener1, Brian H Mullis, Ryan K Harrison
1Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN 46278, USA.
Objectives:
To determine if bioabsorbable pins can be used for stabilization of comminuted articular fragments in periarticular fractures with adequate quality of fixation, while eliminating the potential complications related to use of traditional implants.
Design:
Multicenter retrospective review.
Setting:
Two Level 1 trauma centers.
Patients/Participants:
Institutional billing records identified all cases (83) in which bioabsorbable pins were implanted. All charts were reviewed, and all periarticular fracture cases (80 fractures in 78 patients) were included.
Intervention:
Open reduction and internal fixation of highly comminuted periarticular fractures, using bioabsorbable poly-p-dioxanone and poly-l-lactic acid pins to stabilize the fragments of articular surface.
Main Outcome Measurements:
Outcomes were determined by maintenance of articular reduction assessed at 6 weeks and 3 months; development of posttraumatic arthritis assessed radiographically and by clinical examination at 1 year postoperatively; and rates of local complications including infection, pin migration, and pin-related soft tissue complications evaluated by complete medical record review.
Results:
No patients showed loss of articular reduction at 6 weeks or 3 months. There were no pin-related local complications or pin migration and no instances of delayed union or nonunion. Radiographs showed 19% arthritic changes at 12 months, with 16% loss to follow-up. Infection rate was 6%.
Conclusions:
In highly comminuted periarticular fractures, bioabsorbable pins are an intriguing alternative to traditional fixation methods. They afford similar effectiveness in maintaining stability without evidence of pin migration or other concerns of buried metallic implants.
