Absorbable Rods in Salter’s
Osteotomy
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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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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