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Correct techniques for the use of bioabsorbable implants in orthopaedic trauma

Zamora, Rodolfo MD; Jackson, Adam MD; Seligson, David Prof, MD

doi: 10.1097/BCO.0000000000000378
Innovations in Practice

Since the mid 1980s, the materials and designs of bioabsorbable screws and rods have improved with better biocompatibility, absorbability, and biomechanics, thus reducing the rate of complications. This article describes the differences in the placement of bioabsorbable materials and conventional materials and how the differences affect applicability in orthopaedic procedures. Bioabsorbable screws and pins can be used for different types of fractures. However, when used it is important to consider the differences between bioabsorbable and conventional materials during the surgical technique. When using bioabsorbable materials, the following must be considered: the bone surface should be fully seen, even cannulated screws; the entire length of the pilot hole requires drilling or tapping; screws and rods are nonreversible; drilling of bioabsorbable materials is possible, if required; screws or rods, if long or prominent, can be cut or shaped to avoid skin complications; bioabsorbable implants cannot be seen on radiography (a drill bit or Kirschner wire must be used to assure that the final position of the screw or rod will be correct); and there are no self-adjustment properties when bioabsorbable screws or rods are inserted. Conventional materials and bioabsorbable materials require different insertion strategies. Recognizing these differences will help in the application of bioabsorbable implants and decrease the rate of complications.

Department of Orthopaedic Surgery, University of Louisville, School of Medicine

Financial Disclosure: Dr. Seligson has received a research grant for University of Louisville from Pacira Lab. He has been paid for expert testimony for Boehl Stophie. He is a consultant for Stryker and has received royalties from Springer. The other authors have no disclosures. The authors report no conflicts of interest in regard to this work.

Correspondence to David Seligson, University of Louisville, School of Medicine, Orthopaedic Surgery Department, 550 S. Jackson St, ABC Building- Third Floor Bridge, Louisville, KY 40292 Tel: +1(502)852-0923; fax: +1(502)852-8951; e-mail: DAVID.seligson@louisville.edu.

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