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Endocrine Abstracts (2022) 81 RC8.7 | DOI: 10.1530/endoabs.81.RC8.7

ECE2022 Rapid Communications Rapid Communications 8: Calcium and Bone (7 abstracts)

The resorption status of magnesium screws for surgical treatment of ankle fractures assessed by HRpQCT – 2.5 years follow-up data of a first-in-human study

Ines Fößl 1 , Victor Labmayr 2 , Ulrike Wittig 2 , Annelie Martina Weinberg 2 , Patrick Holweg 2 & Barbara Obermayer-Pietsch 1


1Medical University of Graz, Division of Endocrinology, Department of Internal Medicine, Graz, Austria; 2Medical University of Graz, Department of Orthopedics and Traumatology, Graz, Austria; I.F. and V.L. equally contributed as first authors; P.H. and B.O-P. equally contributed as last authors


Background: Bioresorbable screws for surgical fracture treatment are of great interest for the orthopaedic community. Such implants are designed to provide stability and compression of the fracture and should dissolve after healing, thereby making removal of surgical material obsolete. Magnesium implants are a new material option. So far, long-term follow-up of fracture healing and material decay has not been studied in human. Here, we present the results of the 2.5 year follow-up of 6 patients with medial malleolus fractures after surgical stabilization with magnesium screws.

Design and Methods: 6 patients with isolated, bimalleolar or trimalleolar ankle fractures were surgically treated using bioresorbable screws (magnesium 99.1%, calcium 0.45%, zinc 0.45%) with an initial volume of 243,3 mm3 (+/- 5). Fracture healing was assessed clinically after one year. Implant resorption was studied after 2.5 years with HR-pQCT (high resolution peripheral quantitative computed tomography). Screw residues were carefully evaluated in a binary approach for every slice (residual present vs not present). Zones of degradation without visible bone were contoured manually and the volume was evaluated.

Results: All patients showed clinical evidence of fracture healing confirmed by plain radiographs, with full weight bearing and absence of pain in the fractured ankle after 1 year. After 2.5 years, resorption of the implant material was almost complete. Of the 11 implants in 6 patients, 3 were dissolved without visible residuals whereas at 8 implantation sites minimal residuals were observed, as assessed by HR-pQCT. In 10% of slices (min. 0%; max. 33%) residuals were observed at implant sites. The degradation zones lacked visible ingrowth of new bone for the most part. Mean volume of degradation zones was 504.8 mm3 (min. 239.2 mm3; max. 1109.1 mm3).

male, 32 yearsfemale, 51 yearsfemale, 58 yearsmale, 59 yearsmale, 33 yearsmale, 23 years
Slices with residuals (ventral implant)175/532 (33%)102/610 (17%)41/541 (8%)68/557 (12%)27/525 (5%)0/596 (0%)
Slices with residuals
(dorsal implant)133/495 (27%)13/541 (2%)35/555 (6%)0/531 (0%)N/A0/558 (0%)

Conclusion: Considering the successful fracture healing and excellent clinical outcome after one year, bioresorbable magnesium screws are a viable option for fracture fixation. Implant removal is not necessary and the 2.5 year follow-up showed the screw material largely resolved. However, enlarged degradation zones and the lack of new bone in these zones were observed.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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