Treating Simple Tibia Fractures with Poly-DL-Lactic Acid Screw as a Locked Intramedullary Nail

Purpose: To investigate the curative effect of poly-DL-lactic acid (PDLLA) absorbable screw as a locked intramedullary nail for simple tibia fractures.
Methods: In this study, 35 patients treated with the PDLLA screw were observed, and another 35 patients treated with a traditional locking intramedullary nail were treated as controls. Intraoperative blood loss, postoperative complications, fracture-healing time, and Johner-Wruh grade at the last followup time point of the two treatment groups were compared.
Results: No patients experienced neurovascular injury during the operation, and no significant difference was observed in the operation and intraoperative blood loss of both two groups (p > 0.05). Postoperative x-ray results showed that the counterpoint and alignment of the fractures were favorable and that no rotational displacement had occurred. The follow-up period for all patients was 6 - 24 months, with a mean of 15.6 ± 6.7 months. All patients treated with PDLLA screw were observed to have well-healed tibia fractures, while three patients in the traditional treatment group appeared to have undesirable fracture healing. No infection, breakage of the internal fixator, or rotational displacement was found in either of the two groups, and no significant difference was observed in complication incidence between the two groups (p > 0.05). Additionally, Johner-Wruh grading showed no statistically significant difference between the two groups (p > 0.05). Interestingly, the fracture-healing time of the PDLLA screw-treated patients was significantly shortened compared with that of traditional treatment patients (p < 0.05).
Conclusion: PDLLA screw, as a locked intramedullary nail, is a promising treatment for simple tibia fractures.

Keywords
Simple tibia fracture; Fracture healing time Poly-DL-lactic acid; Poly-DL-Lactic Acid; Absorbable screw; Dynamic stabilization; Internal fixator