ABSTRACT
PURPOSE: The purpose of this article is to show the efficacy of a bioabsorbable polylactide (PLA) screw for treating syndesmotic injuries of ankle fractures. MATERIALS AND METHODS: Ten patients who underwent an open reduction and internal fixation operation for ankle fractures that had syndesmotic injuries from Dec. 1992 to Feb. 1997 were enrolled into the study. There were 6 men and 4 women. The average age of the patients was 42.6 years and the average follow-up period was 2 years 7 months. The cases were analyzed by clinical and radiological findings at the time of their last follow-up evaluation. RESULTS: According to the clinical results, there was statistically no significant difference between finding an average of 15.8 degrees of dorsiflexion and 45.8 degrees of plantar flexion of the ankle on the affected side of the individuals and that of 17.8 degrees of dorsiflexion and 48.5 degrees of plantar flexion on their normal contralateral side. Upon radiological analysis, the medial clear space was decreased from 7.3+/-1.8 mm to 3.1+/-1.0 mm, the tibio-fibular clear space was decreased from 7.8+/-0.9 mm to 4.9+/-0.5 mm and the tibio-fibular overlap increased from 4.6+/-1.8 mm to 10.5+/-1.4 mm. Also there was no pain and instability in the affected side in any of the patients at the time of the last follow-up. CONCLUSION: A bioabsorbable PLA screw is a good implant for stabilizing syndesmotic injuries of the ankle fractures because there is no evidence of a significant osteolysis resulting around the implant, there is a gradual transfer of stress to the surrounding bone, and there is no requirement for a subsequent removal.
Subject(s)
Female , Humans , Male , Ankle Fractures , Ankle Injuries , Ankle , Follow-Up Studies , OsteolysisABSTRACT
PURPOSE: To analyze the results of the foreign body reaction to polyethylene, polymethylmethacrylate, and metal debris and effect on bone by comparing histopathologic finding of pseudomembrane (interface membrane) which was obtained from failed cemented or cementless THA by aseptic loosening. MATERIALS AND METHODS: Of total 50 cases, we analyzed results between 25 cases of cemented THA and 25 cases of cementless THA. Follow-up period between primary and revision THA was average 8 years 5 months. Tissue specimens were harvested, stained with Hematoxylin-Eosin, and examined by light microscope. Histologic study of various items was done. RESULTS: The fibrous membrane between bone-to-cement or bone-to-metal could be roughly divided into three distinct histological layers in cross section histopathology. These tissues were characterized by histiocytes, infiltration of foreign body giant cells and fibrosis in all specimens, and infiltration of lymphocytes and plasma cells was relatively rare, and aggregation of polymorphonuclear leukocytes was invisible. CONCLUSION: Although there were no significant differences in histologic findings between the regions of ten tissue specimens, there was significant difference between the degree of polyethylene or cement debris in numbers and the degree of foreign body reaction associated with increased infiltrations of giant cells, and foreign body reaction to polyethylene debris seems to be main cause of aseptic loosening of prosthesis.