Our Summary

This research paper discusses the use of bioabsorbable materials in treating fractures of the scaphoid bone in the wrist, which account for most injuries to the carpal bones. The scaphoid has a limited blood supply, so it’s crucial that fractures to it heal properly to avoid complications like bone death. There’s been a lot of recent interest in developing devices made from bioabsorbable materials that can be used to treat these fractures without needing to be removed later or causing other problems.

The researchers looked at several databases to find studies on using bioabsorbable materials in scaphoid fixation and how patients did after their operations. They found 124 studies and included 7 of them in their review, which involved 79 patients. The most common material used for scaphoid fixation was a derivative of Poly-L-Lactic acid, with magnesium and polyglycolide also used.

The results were mixed but generally showed that bioabsorbable materials were about as effective as traditional metal screws. However, the researchers concluded that more research is needed to fully understand how well these bioabsorbable devices work and when they should be used in treating scaphoid fractures.

FAQs

  1. What are bioabsorbable materials and why are they used in scaphoid fracture surgery?
  2. What was the most common bioabsorbable material used for scaphoid fixation in the studies reviewed?
  3. What were the results of the research on the use of bioabsorbable materials in scaphoid fixation surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scaphoid fracture surgery is to follow post-operative instructions carefully, including keeping the wrist immobilized as directed and attending follow-up appointments to monitor healing progress. It’s important to follow a rehabilitation program to regain strength and range of motion in the wrist after surgery. Additionally, avoiding activities that could put stress on the healing bone is crucial to ensure proper healing. Finally, maintaining a healthy lifestyle with a balanced diet and adequate hydration can support the body’s natural healing processes.

Suitable For

Patients who are typically recommended scaphoid fracture surgery are those with displaced fractures, fractures that are not healing properly on their own, or fractures that are at risk of complications such as avascular necrosis (bone death) due to the limited blood supply to the scaphoid bone. Surgery may also be recommended for patients with fractures that are non-union (not healing at all) or malunion (healed in an incorrect position).

Additionally, patients who are physically active or have high demands on their wrists, such as athletes or manual laborers, may also be recommended surgery to ensure proper healing and restore function to the wrist. Patients with multiple fractures, open fractures, or fractures that involve other structures in the wrist may also be candidates for surgery.

Ultimately, the decision to recommend surgery for a scaphoid fracture will depend on the specific characteristics of the fracture, the patient’s overall health and activity level, and the potential risks and benefits of surgery versus conservative treatment. Consulting with a hand surgeon or orthopedic specialist is recommended to determine the best course of treatment for each individual patient.

Timeline

Before scaphoid fracture surgery:

  1. Patient experiences pain, swelling, and limited range of motion in the wrist.
  2. X-rays are taken to diagnose the fracture and determine the best course of treatment.
  3. Patient may undergo conservative treatment such as casting or splinting to immobilize the wrist and allow the fracture to heal.

After scaphoid fracture surgery:

  1. Patient undergoes surgery to stabilize the fracture, typically with metal screws or bioabsorbable materials.
  2. Recovery involves wearing a cast or splint to immobilize the wrist for several weeks.
  3. Physical therapy may be necessary to regain strength and range of motion in the wrist.
  4. Follow-up appointments and imaging studies are done to monitor the healing process and ensure the fracture has fully healed.
  5. Patient gradually resumes normal activities and may need to avoid certain high-impact activities to prevent re-injury.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scaphoid fracture surgery using bioabsorbable materials include:

  1. What are the potential benefits of using bioabsorbable materials for scaphoid fracture surgery compared to traditional metal screws?
  2. Are there any potential risks or complications associated with using bioabsorbable materials for scaphoid fixation?
  3. How long does it typically take for the bioabsorbable material to be fully absorbed by the body after surgery?
  4. Will I need any additional surgeries or procedures to remove the bioabsorbable material once it has been absorbed?
  5. How does the recovery process differ when using bioabsorbable materials compared to traditional metal screws for scaphoid fixation?
  6. Are there any specific factors or characteristics of my injury that make me a good candidate for using bioabsorbable materials for scaphoid fracture surgery?
  7. What is the success rate of using bioabsorbable materials for scaphoid fixation, and what can I expect in terms of long-term outcomes?
  8. Are there any ongoing clinical trials or research studies investigating the use of bioabsorbable materials for scaphoid fractures that I should be aware of?
  9. How experienced are you and your team in performing scaphoid fracture surgery using bioabsorbable materials?
  10. Are there any alternative treatment options for my scaphoid fracture that I should consider before deciding on surgery with bioabsorbable materials?

Reference

Authors: Feeley A, Feeley I, Ni Fhoghlú C, Sheehan E, Kennedy M. Journal: Clin Biomech (Bristol). 2021 Oct;89:105480. doi: 10.1016/j.clinbiomech.2021.105480. Epub 2021 Sep 8. PMID: 34530377