Titanium versus Biodegradable Implants for Fracture Fixation: A Retrospective Comparative Study.

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Trauma management

Background:

• Titanium alloy implants provide mechanical stability but necessitate removal surgeries.
• Biodegradable implants avoid removal but raise concerns about mechanical strength in load-bearing applications.
• This study compares titanium and biodegradable implants for limb and pelvic fractures, evaluating the trade-off between rigidity and secondary surgery burden.

Purpose of the Study:

• To compare the clinical outcomes of titanium versus biodegradable implants in fracture fixation.
• To assess implant palpability, reoperation rates, and the need for secondary surgeries.
• To evaluate the suitability of each implant type based on fracture location and weight-bearing requirements.

Main Methods:

• Retrospective cohort study of 73 patients (November 2021 - August 2024).
• Groups: Titanium (n=40, diaphyseal fractures) and Biodegradable (n=33, metaphyseal/peri-articular fractures).
• Outcomes assessed: implant palpability, reoperation rates, and stratified analysis for weight-bearing fractures.

Main Results:

• Titanium implants showed significantly higher palpability (45.0% vs 9.1%) and reoperation rates (35.0% vs 9.1%).
• Elective removal for discomfort was common with titanium (17.5%) but absent with biodegradable implants.
• Biodegradable implants reduced palpability in weight-bearing fractures without increasing complications, but refractures occurred (9.1% vs 0%).

Conclusions:

• Biodegradable implants are advantageous for metaphyseal/peri-articular fractures, reducing palpability and elective removal surgeries.
• Titanium remains preferred for diaphyseal fractures due to its superior mechanical stability.
• Study limitations include retrospective design and fracture site heterogeneity.