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Absorbable Rods in Salter's Osteotomy: A Comparison of SR-PGA and SR-PLLA, Slides of Orthopedics

Information on the use of absorbable rods in salter's osteotomy, a surgical procedure for treating acetabular dysplasia. The advantages and disadvantages of using self-reinforced polyglycolic acid (sr-pga) and self-reinforced poly-levo lactic acid (sr-plla) rods, including their initial bending strength, loss of strength, and complete resorption rates. The document also mentions the problems associated with k-wires and the potential benefits of replacing them with absorbable rods. Studies on the use of absorbable rods in pediatric fractures are also cited.

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2011/2012

Uploaded on 12/14/2012

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Absorbable Rods in Salters
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Download Absorbable Rods in Salter's Osteotomy: A Comparison of SR-PGA and SR-PLLA and more Slides Orthopedics in PDF only on Docsity!

Absorbable Rods in Salter’s

Osteotomy

  • First published: JBJS 1961, 43B: 518-
  • Redirectional acetabuloplasty
  • Easy to perform
  • The commonest performed acetabuloplasty
  • Two K-wires are used to fix the graft and

stabilize the osteotomy

Salter’s Osteotomy

Problems of K-wires

  • Protrusion
  • Infection
  • Migration
  • Second surgery
    • Anesthesia, scar, bed, socio-economic

Salter’s Osteotomy

Replace K-wires with absorbable rods?

Salter’s Osteotomy

Material Type Size

SR-PGA Rods Diam. 1.1 – 4.5 mm Length 10 – 70 mm SR-PLLA Rods PDS Rods Diam. 1.3 / 2 mm Length 40 mm

Materials Available

Material Initial Bending Strength Steel 310 – 690 (depends on geometry) SR-PGA 410 SR-PLLA 300 Cancellous bon 210 Cortical bone 120 PDS 60

Materials Strength

Loss of Strength

This image cannot currently be displayed. Bending Strength Sheering Strength Steel (^) SR-PGA (^) SR-PLLA

Absorbable Rods in Ped. Fractures

  • Pediatric Elbow Fractures Hope et al (JBJS 1991) Makela et al (Clin. Orthop. 1992) Bostman et al (J. ped. Orthop. 1993)
  • Supracondylar fractures Bostman et al (J Ped Orthop 1993)

Absorbable Rods in Acetabuloplasty

  • Report of 28 dysplastic hips.
    • SR-PLLA screws. Nakamura et al, Act Orthop Scan, 1993
  • Rotational Acetabular Osteotomy :
    • 41 pt. (age 12 - 55 y )
    • SR-PLLA screws. Nakamura et al, Int Orthop, 1999

Absorbable Rods in Salter’s Osteot. Salter’s Osteotomy : 18 hips.

SR-PGA Rods 1.5 mm.

Follow up  13 - 34 months (mean 25m).

Results:

15 healed well : no complications.

3 slipped : 1 pt. too old ( 9 y ).

2 pt. misplaced rods.

M Kremli: J Ped Orthop B 11 No 2, 2002 Started in 1998

Results

Bilateral : 9 patients

• 7 patients:

– k-wire on one side and absorbable rod

on the other side.

M Kremli: J Ped Orthop B 11 No 2, 2002

Results

Type of Surgery

• Salter’s only 6

• Salter’s and Open reduction

• Salter’s and Open and Femoral 4

M Kremli: J Ped Orthop B 11 No 2, 2002

Complications

  • Wound infection : none
  • Inflammatory reaction : none
  • Femoral fracture : 1
  • Displaced graft : 3 M Kremli: J Ped Orthop B 11 No 2, 2002

Complications

Failures

(Displaced Graft and Osteotomy)

WHY?

M Kremli: J Ped Orthop B 11 No 2, 2002