Abstract
Summary. The efficiency of using the dynamic blocking intramedullary osteosynthesis (BIOS) technique for tibial fractures with the use of biodegradable implants based on the MS-10 magnesium alloy was determined.
Objective: to approve the technique and to study the effectiveness of dynamic intramedullary osteosynthesis of diaphyseal fractures of the tibia using locking screws made of the biodegradable magnesium alloy MS-10.
Materials and Methods. The study was carried out in the Department of Traumatology of the Municipal Non-Profit Enterprise “City Hospital of Emergency and Ambulance” of Zaporizhzhia City Council in Zaporizhzhia on 15 patients with diaphyseal fractures of the tibia, who underwent BIOS. Cannulated intramedullary titanium rods were used as a fixator. In the proximal section, a screw made of titanium alloy was introduced into a dynamic hole; a screw made of a biodegradable magnesium alloy MC-10 was inserted into a static hole. In the postoperative period, the patients underwent a course of complex rehabilitation measures. X-ray control was performed on day 1, at week 4, week 8, and week 16 after the surgery.
Results. After the start of the dosed load on the injured limb, a fracture of the locking screw made of MC-10 alloy was radiographically recorded in all patients. The dynamic screw moves in the dynamic hole and the fracture is dynamized. The formation of callus in the fracture zone was unremarkable and took an average physiological time. The quality and structure of callus did not show any pathological features. Four months after the surgery, all patients were socially adapted and did not use additional support when moving.
Conclusions. Based on the data obtained, it is possible to draw a conclusion about the possibility and advisability of using biodegradable implants made of magnesium alloy MS-10 in a dynamic BIOS of long bones of the human skeleton.
References
Baumgaertel F, Dahlen C, Stiletto R, Gotzen L. Technique of using the AO femoral distractor for femoral intramedullary nailing. J. Orthop. Trauma. 1994 Aug;8(4):315-21. DOI: 10.1097/00005131-199408000-00007.
Behrens F, Searls K. External fixation of the Tibia. Basic concept and prospective evaluation. J. Bone Joint Surg. 1986;68B(2):246-54. DOI: 10.1302/0301-620X.68B2.3514629.
Гайко ГВ, Калашников АВ, Вдовиченко КВ, Чалайдюк ТП. Анализ результатов лечения диафизарных переломов большеберцовой кости при использовании различных видов остеосинтеза. Остеосинтез. 2012;3(20):6-20.
Gayko GV, Kalashnikov AV, Vdovichenko KV, Chalaydyuk TP. Analysis of the results of treatment of diaphyseal fractures of the tibia using various types of osteosynthesis. Osteosintez. 2012;3(20):6-20. [in Russian].
Климовицький ВГ, Оксимець ВМ. Симпозіум «Переломи, що не зрослися, та псевдоартрози». Травма. 2012;13(4):166-74.
Klymovytskyi VH, Oksymets VM. Symposium "Unfused fractures and pseudoarthrosis". Travma. 2012;13(4):166-74. [in Ukrainian].
Zimmermann G, Moghaddam A. Trauma: Non-Union: New Trends. In: Bentley G, editor. European Instructional Lectures 10. 11th EFORT Congress; 2010 Mar. 24; Madrid, Spain; 2010. р. 15-19. DOI: 10.1007/978-3-642-11832-6_2.
Lefaivre KA, Guy P, Chan H, Blachut PA. Long-term follow-up of tibial shaft fractures treated with intramedullary nailing. J Orthop Trauma. 2008;22(8):525-9. DOI: 10.1097/BOT.0b013e318180e646.
Busse JW, Morton E, Lacchetti C, Guyatt GH, Bhandari M. Current management of tibial shaft fractures: a survey of 450 Canadian orthopedic trauma surgeons. Acta Orthop. 2008;79(5):689-94. DOI:10.1080/17453670810016722.
Leung K, Taglang G, Schnettler R, Alt V, Haarman HJTM, Seidel Н, et al, editors. Practice of Intramedullary Locked Nails. Berlin: Springer-Verlag Berlin Heidelberg; 2006. 286 p.
Романенко КК, Белостоцкий АИ, Прозоровский ДВ, Голка ГГ. Функции и виды пластин и винтов в современном остеосинтезе. Ортопедия, травматология и протезирование. 2010;(1):68-75.
Romanenko KK, Belostotskiy AI, Prozorovskiy DV, Golka GG. Functions and types of plates and screws in modern osteosynthesis. Ortopediya, travmatologiya i protezirovanie. 2010;(1):68-75. [in Russian].
Сергеев СВ, Загородний НВ, Абдулхабиров МА, Гришанин ОБ, Карпович НИ, Папоян ВС. Современные методы остеосинтеза костей при острой травме опорно-двигательного аппарата. Учебное пособие. Москва: Российский университет дружбы народов; 2008. Глава 2, Переломы, классификация, принципы лечения, заживление; с. 40-7.
Sergeev SV, Zagorodniy NV, Abdulkhabirov MA, Grishanin OB, Karpovich NI, Papoyan VS. Modern methods of osteosynthesis of bones in acute trauma of the musculoskeletal system. Tutorial. Moskva: Rossiyskiy universitet druzhby narodov; 2008. Chapter 2, Fractures, classification, principles of treatment, healing; s. 40-7. [in Russian].
Salem НH. Unreamed intramedullary nailing in distal tibial fractures. Int Orthop. 2013;37(10):2009-15. DOI: 10.1007/s00264-013-1998-y.
Vaughn J, Gotha H, Cohen E, Fantry AJ, Feller RJ, Meter JV, et al. Nail dynamization for delayed union and nonunion in femur and tibia fractures. Orthopedics. 2016;39(6):e1117-23. DOI: 10.3928/01477447-20160819-01.
Школьникова МА. Метаболизм магния и терапевтическое значение его препаратов. Пособие для врачей. Москва: Медпрактика; 2002. 32 с.
Shkolnikova MA. Magnesium metabolism and the therapeutic value of its drugs. A guide for doctors. Moskva: Medpraktika; 2002. 32 s. [in Russian].
Верткин АЛ, Городецкий ВВ. Применение магния в кардиологии. Кардиология. 1997;37(11):96-9. eLIBRARY ID: 37285620.
Vertkin AL, Gorodetskiy VV. The use of magnesium in cardiology. Kardiologiya. 1997;37(11):96-9. [in Russian]. eLIBRARY ID: 37285620.
Яцун ЄВ, Чорний ВМ, Головаха МЛ. Перспективи застосування біодеградуючих сплавів на основі магнію в остеосинтезі (літературно-аналітичний огляд). Проблеми військової охорони здоров'я. 2013;36:141-8.
Yatsun YeV, Chornyi VM, Holovakha ML. Prospects for the use of biodegradable magnesium-based alloys in osteosynthesis (literature-analytical review). Problemy viiskovoi okhorony zdorovia. 2013;36:141-8. [in Ukrainian].
Тертишний СІ, Дикий КЛ, Головаха МЛ, Чорний ВН, Яцун ЄВ. Морфогенез репаративної регенерації кісткової тканини в умовах застосування магній-резорбуючих імплантів. Патологія. 2012;(3):85-8.
Tertyshnyi SI, Dykyi KL, Holovakha ML, Chornyi VN, Yatsun YeV. Morphogenesis of reparative bone regeneration under conditions of magnesium-resorbing implants. Patolohiia. 2012;(3):85-8. [in Ukrainian].
Нерянов ЮМ, Головаха МЛ, Бєленічев ІФ, Чорний ВМ, Яцун ЄВ. Дослідження токсичної дії продуктів біодеградації магнієвого сплаву в експерименті. Патология. 2013;2(28):68-71.
Nerianov YuM, Holovakha ML, Bielenichev IF, Chornyi VM, Yatsun YeV. Investigation of the toxic effects of magnesium alloy biodegradation products in an experiment. Patolohyia. 2013;2(28):68-71. [in Ukrainian].
Staiger MP, Pietak AM, Huadmai J, Dias G. Magnesium and its alloys as orthopedic biomaterials: a review. Biomaterials. 2006;27:1728-34. DOI: 10.1016/j.biomaterials.2005.10.003.
Waizy H, Seitz JM, Reifenrath J, Weizbauer A, Bach FW, Meyer-Lindenberg A, et al. Biodegradable magnesium implants for orthopedic applications. J Mater Sci. 2013;48:39–50. DOI: 10.1007/s10853-012-6572-2.
Modrejewski C, Plaab C, Ettinger S, Caldarone F, Windhagen H, Stukenborg-Colsman C, und andere. Degradationsverhalten bioresorbierbarer Magnesium-Implantate bei distalen Metatarsale-1-Osteotomien im MRTDegradation behavior of Magnesium-alloy srews after distal metatarsal osteotomies in MRI. Fuß & Sprunggelenk. 2015;13(3);156-61. DOI: 10.1016/j.fuspru.2015.06.002.
Черный ВН, Яцун ЕВ, Головаха МЛ. Исторические аспекты применения биодеградирующих сплавов на основе магния для остеосинтеза (обзор литературы). Ортопедия, травматология и протезирование. 2014;(1):105-9.
Chernyy VN, Yatsun YeV, Golovakha ML. Historical aspects of the use of biodegradable magnesium-based alloys for osteosynthesis (literature review). Ortopediya, travmatologiya i protezirovanie. 2014;(1):105-9. [in Russian].
This work is licensed under a Creative Commons Attribution 4.0 International License.