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Clinical Application of Resorbable Biomaterials in Reconstructive Surgery

  • K. E. Rehm

Abstract

Until now we don’t really know how much stability is needed for undisturbed bone healing. Usual metal fixation in fracture treatment is without any doubt a successful procedure. Cortical bone and steel are very different materials, especially concerning the elastic properties. The elasticity constant of bone is only 1/10 of implant steel, and tensile strength is 10 times lower. In the months following internal fixation, bone substance is decreasing as a matter of deviation of force over the implant. The removal of metal implants is followed by a period of weakened bone (stress protection) with the danger of refractture or second fracture. Bone healing is a dynamic procedure, starting with no stability at all up to regulär strength. The idea of biodegradable implants depends on the reflected image of the bone, that means a decreasing weightbearing of the material. After months, the whole material has disappeared completely and no secondary surgery is needed. Besides the costs, time of treatment and uncomfort of the patient descends. Polymer materials which are hopeful for this indication are Polyglycolide, Polylactide, Polydioxanone and Polyhydroxy- butyrate. The physical data are well known and do not differ fundamentally. They can be improved by higher molecular weight and various kinds of treatment after polymerisation. Copolymers are investigated as well as Compound materials. Because we need a complete system for internal fixation, the development of biodegradable implants has five aims: the replacement material for K-wires, flexible wires, cords, plates and screws.

Keywords

Anterior Cruciate Ligament Internal Fixation Radial Head Pelvic Ring Ankle Fracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Dociu, N., P. Hein: PDS - ein neues chirurgisches Nahtmaterial Ethicon OP-Forum (1981) 108Google Scholar
  2. 2.
    Keller, H.W., K.E. Rehm: Die Versorgung der kompletten Schultereckgelenkssprengung ohne metallisches Implantat Unfallchirurg 94 (1991) 511–513Google Scholar
  3. 3.
    Rehm, K.E.: Die geschlossene Kreuzbandplastik Unfallchirurgie 7 No. 2 (1981) 55–59CrossRefGoogle Scholar
  4. 4.
    Rehm, K.E., K.H. Schultheis, P. Bopp, H. Ecke: Biomechanische Untersuchungen vom resorbierbaren Bandersatz und deren klinische Bedeutung Langenbecks Arch. Chir. Suppl. (1984) 207–211Google Scholar
  5. 5.
    Rehm, K.E., B. Kaletsch: Mikrogefässanastomosen mit resorbierbarem oder nicht resorbierbarem Nahtmaterial in: Biomaterialien und Nahtmaterial, S. 298–302 Hrsg.: H. Rettig Springer Verlag, Berlin - Heidelberg 1984Google Scholar
  6. 6.
    Rehm, K.E.: Versorgung der Schultereckgelenkssprengung ohne metallisches Implantat in: Biomechanik der gesunden und kranken Schulter, S. 47–48 Hrsg. H.J. Refior, W. Plitz, M. Jäger u. M. Hackenbroch Thieme Verlag, Stuttgart - New York 1985Google Scholar
  7. 7.
    Rehm, K.E., K.H. Schultheis: Bandersatz mit Polydioxanon (PDS) Unfallchirurgie 5 (1985) 264–273CrossRefGoogle Scholar
  8. 8.
    Rehm, K.E.: Biodegradable implants in Traumatology and Reconstructive Surgery: Stage of development and clinical significance Polymery W Medycynie PWN-Polish Scientific Publishers T XVIII No. 3 (1988) 117Google Scholar
  9. 9.
    Rehm, K.E.: Entwicklungsstand und klinische Bedeutung von resorbierbaren Osteosynthesematerialien Hefte zur Unfallheilkunde 200 (1988) 663Google Scholar
  10. 10.
    Rehm, K.E., H.J. Helling, L. Claes: Biologisch abbaubare Osteosynthesematerialien in: Jahrbuch der Chirurgie (1989) S. 223–232 Biermann Verlag, Zülpich 1989Google Scholar
  11. 11.
    Rehm, K.E.: Biodegradable Implants in Traumatology and Reconstructive Surgery Chemia Stosowana 34, No. 1-2 (1990), 41–48Google Scholar
  12. 12.
    Rehm, K.E.: Kreuzbandaugmentationsplastik mit Patellarsehne und PDS- Kordel Serie “Im Dienste der Chirurgie” 72 Ethicon, Hamburg (1990)Google Scholar
  13. 13.
    Zieren, H.U., W.A. Holzmüller, J. Rosenberger, K.E. Rehm Sind Patellazuggurtungen mit resorbierbaren Materialien möglich? Unfallchirurg 94 (1991) 634–639Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • K. E. Rehm
    • 1
  1. 1.Trauma-, Hand- and Reconstructive SurgeryUniversity of CologneCologneGermany

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