[Resorbable rods and screws of polyglycolide in stabilizing malleolar fractures. A clinical study of 600 patients].

Absorbable internal fracture fixation implants have been in large-scale clinical use since 1984. The main advantage of these devices is that no subsequent operation for implant removal is required. In this study the results obtained in a series of 600 patients with displaced malleolar fractures who were operated on over a 6-year period (1985-1990) using rods or screws made of polyglycolide were analysed. Rod fixation was used in 63% and screw fixation in 37% of the patients. Recovery was uneventful in 91.5%. Bacterial wound infection occurred in 1.2% and failure of fixation necessitating reoperation in 0.8% (5 patients). In 4 of these 5 patients a refixation procedure with AO devices was performed. In one elderly patient with failed fixation talocrural arthrodesis had to be done. A sterile inflammatory foreign-body reaction complicated the course in 6.5%. The incidence of these reactions was higher during the early years of the study, when the implants contained an aromatic quinone dye, than later, when stain-free implants were used. The foreign-body reactions were transient and did not significantly influence the ultimate results of treatment. During the 6-year period the use of absorbable implants has made it possible for resources corresponding to several hundred hardware removal procedures to be used for other purposes.