Background

Scaphoid fractures account for 60–70% carpal injury. Due to limited vascular supply achieving adequate reduction and healing is important to avoid complications including avascular necrosis. Recent technological advances have led to renewed vigour in bioabsorbable material research to develop devices which could be used without the need for removal and complications including stress shielding and suboptimal imaging.

Methods

A systematic search of databases including PubMed, Ovid Medline, and Google Scholar databases was made to identify studies related to the use of bioabsorbable materials in scaphoid fixation and postoperative patient outcomes. PRISMA guidelines were utilised for this review.

Findings

Initial search results yielded 852 studies. 124 studies were screened, with 79 patients across 7 studies included in this review. Poly-L-Lactic acid derivatives were the most common biomaterial for scaphoid fixation, with magnesium and polyglycolide also used. Levels of evidence for studies ranged between III-IV. Analysis demonstrated mixed findings with generally comparable outcomes to conventional alloy-based screws.

Interpretation

Development in bioabsorbable materials is ongoing, however there remains a dearth in data regarding their use in the scaphoid. Further research is needed to establish the efficacy and applicability of bioabsorbable devices in the scaphoid bone.

中文翻译：

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生物材料在舟骨骨折固定中的应用，系统评价

背景

舟状骨骨折占腕骨损伤的 60-70%。由于血管供应有限，实现充分减少和愈合对于避免包括缺血性坏死在内的并发症很重要。最近的技术进步导致生物可吸收材料研究重新焕发活力，以开发无需移除和并发症（包括应力屏蔽和次优成像）即可使用的设备。

方法

对包括 PubMed、Ovid Medline 和 Google Scholar 数据库在内的数据库进行了系统搜索，以确定与在舟状骨固定和术后患者结果中使用生物可吸收材料相关的研究。本次审查使用了 PRISMA 指南。

发现

最初的搜索结果产生了 852 项研究。筛选了 124 项研究，本综述纳入了 7 项研究的 79 名患者。聚-L-乳酸衍生物是用于舟状骨固定的最常见的生物材料，镁和聚乙交酯也被使用。研究的证据级别介于 III-IV 之间。分析表明混合结果与传统合金螺钉的结果大致相当。

解释

生物可吸收材料的开发正在进行中，但是关于它们在舟状骨中的使用的数据仍然缺乏。需要进一步的研究来确定生物可吸收装置在舟骨中的功效和适用性。