Omer Faruk Egerci, Fırat Dogruoz, Hakan Cetin, Mehmet Baris Ertan, Aliekber Yapar, Ozkan Kose
{"title":"High rate of failure after magnesium bioabsorbable compression screw fixation for scaphoid fractures.","authors":"Omer Faruk Egerci, Fırat Dogruoz, Hakan Cetin, Mehmet Baris Ertan, Aliekber Yapar, Ozkan Kose","doi":"10.1186/s13018-025-05701-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aimed to evaluate the clinical and radiological outcomes of magnesium (Mg) bioabsorbable compression screws in the management of scaphoid fractures and nonunion. Despite theoretical benefits, such as osteoinductive properties and gradual degradation facilitating bone remodeling of these novel implants, clinical evidence on their efficacy remains limited.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 20 patients who underwent scaphoid fracture or nonunion surgery with Mg screws at our hospital between 2015 and 2024. Patients with a minimum of 12 months of radiological follow-up were included. Functional assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) and Mayo Wrist Score, while radiographic outcomes focused on union, screw integrity, and cystic changes. Statistical analysis compared grip strength and wrist range of motion to the contralateral side.</p><p><strong>Results: </strong>The mean clinical follow-up period was 78.3 months (SD ± 22.0; range 14-108), and the mean radiological follow-up was 59.1 months (SD ± 30.5; range 12-99). Functional assessments showed a mean Q-DASH score of 11.5 (SD ± 16.9; range 0-68.2) and a Mayo Wrist Score of 75.7 (SD ± 13.3; range 45-95), indicating moderate functional recovery. The non-union rate was 40%, with complications including screw breakage in 25% of patients and cystic lesion formation around screws in most cases. No infections were reported. Wrist range of motion and grip strength were both significantly reduced on the injured side compared to the intact side.</p><p><strong>Conclusions: </strong>Mg screws demonstrate potential benefits for bioabsorbable fixation, but our findings indicate a high rate of complications, including non-union and screw instability, in scaphoid fractures. The study suggests that Mg screws may not provide adequate stability for complex fractures in small bones like the scaphoid.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"296"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-025-05701-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This retrospective study aimed to evaluate the clinical and radiological outcomes of magnesium (Mg) bioabsorbable compression screws in the management of scaphoid fractures and nonunion. Despite theoretical benefits, such as osteoinductive properties and gradual degradation facilitating bone remodeling of these novel implants, clinical evidence on their efficacy remains limited.
Materials and methods: A retrospective analysis was conducted on 20 patients who underwent scaphoid fracture or nonunion surgery with Mg screws at our hospital between 2015 and 2024. Patients with a minimum of 12 months of radiological follow-up were included. Functional assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) and Mayo Wrist Score, while radiographic outcomes focused on union, screw integrity, and cystic changes. Statistical analysis compared grip strength and wrist range of motion to the contralateral side.
Results: The mean clinical follow-up period was 78.3 months (SD ± 22.0; range 14-108), and the mean radiological follow-up was 59.1 months (SD ± 30.5; range 12-99). Functional assessments showed a mean Q-DASH score of 11.5 (SD ± 16.9; range 0-68.2) and a Mayo Wrist Score of 75.7 (SD ± 13.3; range 45-95), indicating moderate functional recovery. The non-union rate was 40%, with complications including screw breakage in 25% of patients and cystic lesion formation around screws in most cases. No infections were reported. Wrist range of motion and grip strength were both significantly reduced on the injured side compared to the intact side.
Conclusions: Mg screws demonstrate potential benefits for bioabsorbable fixation, but our findings indicate a high rate of complications, including non-union and screw instability, in scaphoid fractures. The study suggests that Mg screws may not provide adequate stability for complex fractures in small bones like the scaphoid.
Level of evidence: Level IV, retrospective cohort study.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
