High rate of failure after magnesium bioabsorbable compression screw fixation for scaphoid fractures.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-03-19 DOI:10.1186/s13018-025-05701-7

Omer Faruk Egerci, Fırat Dogruoz, Hakan Cetin, Mehmet Baris Ertan, Aliekber Yapar, Ozkan Kose

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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.

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可生物吸收镁加压螺钉固定舟状骨骨折失败率高。

目的：本回顾性研究旨在评估生物可吸收镁（Mg）加压螺钉治疗舟状骨骨折和骨不连的临床和影像学结果。尽管这些新型植入物在理论上有好处，如骨诱导特性和逐渐降解促进骨重塑，但其疗效的临床证据仍然有限。材料与方法：回顾性分析2015年至2024年在我院行舟状骨骨折或骨不连Mg螺钉手术的患者20例。患者接受了至少12个月的放射学随访。使用手臂、肩膀和手的快速残疾（Q-DASH）和Mayo手腕评分进行功能评估，而影像学结果主要关注愈合、螺钉完整性和囊性变化。统计分析比较了对侧握力和手腕活动范围。结果：临床平均随访78.3个月(SD±22.0；放射学随访时间为59.1个月(SD±30.5；范围12 - 99)。功能评估显示Q-DASH平均评分为11.5 (SD±16.9；范围0-68.2)，Mayo手腕评分为75.7 (SD±13.3；范围45-95)，表明中度功能恢复。不愈合率为40%，并发症包括25%的患者螺钉断裂，大多数病例螺钉周围形成囊性病变。没有感染报告。与完好的一侧相比，受伤一侧的手腕活动范围和握力都明显减少。结论：Mg螺钉显示出生物可吸收固定的潜在益处，但我们的研究结果表明，舟状骨骨折的并发症发生率很高，包括不愈合和螺钉不稳定。研究表明，对于像舟状骨这样的小骨复杂骨折，Mg螺钉可能不能提供足够的稳定性。证据等级：IV级，回顾性队列研究。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

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.