Successful treatment of scaphoid fractures and nonunions using bioabsorbable screws: report of six cases.

Abstract

A variety of implants have been used for the fixation of scaphoid fractures, but we have found no reports on bioabsorbable screws used for this purpose. We report 6 cases of scaphoid fractures treated with bioabsorbable screws. Six patients with scaphoid waist region fractures (3) and nonunions (3) treated using bioabsorbable self-reinforced poly-L-lactide screws. Interposition of a bone graft from the iliac crest was used in 4 cases. Immobilization in a short arm-thumb spica cast was applied after surgery for an average of 8 weeks. Solid union was achieved in 5 cases. Using the Mayo modified Green-O'Brien wrist score, we graded the results as excellent in 1 case, good in 4 cases, and poor in the single case of nonunion. These results suggest that bioabsorbable self-reinforced poly-L-lactide screws might offer an alternative in the fixation of scaphoid fractures and nonunions in the future, provided that cannulated screws of appropriate size will be available.