Biodegradable internal fixation.

Abstract

The objective of this article was to assess the value of the use of biodegradable materials in internal fracture fixation according to the current literature. Research methods included a computerized Medline search and a hand check of references of identified articles. Also, a complete reference list was obtained from the manufacturer of Biofix (Bioscience Ltd., Tampere, Finland). The reviewers abstracted descriptive information about population, materials, complications, follow-up times in clinical trials and strength of fixation, complications, and population for animal experiments. Results indicated that sterile sinus formation is mostly associated with polyglycolic acid, with rates up to 25%, and to a lesser extent, polylactic acid. Volume of implanted material and vascularity of bone appeared to affect the rate of sinus formation. Absorbable fixation was equivalent to or better than steel fixation for functional outcome refracture rate, and in transepiphyseal femoral and humoral fractures. Polyglycolic acid and polylactic acid both became toxic between 10 days and 4 weeks of hydrolysis. Polyglycolic acid had the highest initial strength at 370 MPa compared with other polymers.