Fixation of Malleolar Fracture Using ActivaScrew™

Esa Partio M.D., Ph.D.

The Patient was an 18 years old male, with high energy snowboarding injury. Preoperative X-ray revealed dislocated Weber B - type fracture with rotational malposition. The fracture was fixed with two fully threaded ActivaScrew™ 4.5 x 50 mm bioabsorbable screws. The functional result of the operation was excellent.

ID: WP01
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Fixation of Malleolar Fracture Using ActivaPin™

Esa Partio M.D., Ph.D.


The patient was a 58 years old normal female, with Weber A -type lateral malleolar fracture. Primary treatment conservatively with 6 weeks plaster cast immobilization and nonunion of the fracture. Two ActivaPin™s were used in angle to create rigid stability and compression to the fragment line. The fracture healed well with exact position and pain in the ankle was relieved.

ID: WP02
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ActivaScrew™ Interference Comparison to PLLA Based Competitors

Bioretec Ltd.

ActivaScrew™ Interference is manufactured from PLGA (85% L-lactide/15% Glycolide). This composition gives ideal absorption properties. ActivaScrew™ Interference`s unique manufacturing technique provides very high initial mechanical properties and produces Self-Locking SL™ feature. Self-Locking SL™ is based on screw diameter change (up to 7%) during first weeks after surgery.

ID: WP03
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First Metatarsophalangeal Arthrodesis Using ActivaScrew™ Cannulated LAG

Heikki Mäenpää M.D., Ph.D

67 years old female patient with severe hallux valgus in the right foot causing pain and severe limitation of physical activity. MTP I arthrodesis was carried out using one 3.5 x 40 and one 3.5 x 45 mm ActivaScrew™ Cannulated LAG. At 6 weeks X-ray showed bony fusion of the MTP I joint.

ID: WP04
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Hallux Valgus Correction Using ActivaPin™ and ActivaNail™

Heikki Mäenpää M.D., Ph.D.


The patient was 43 years old female with medical history of spondyloarthropathy, obesity and fibromyalgia. In order to relieve the pain and restore the normal anatomy of the foot, operative treatment was decided with chevron osteotomy using ActivaPin™ for the first metatarsal head and soft tissue reconstruction. In addition, Weil osteotomy was decided to be carried out on the second metatarsal with ActivaNail™ as a decompressive procedure. ActivaPin™ and ActivaNail™ are well suitable for fixation of chevron, Weil and many other osteotomies in foot surgery.

ID: WP05
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Clinical Application of PLGA Resorbable Screw Fixation in Forefoot Surgery

Charles M Zelen, DPM FACFAS, David L Nielson, DPM

A 40-year-old health care worker with a long-standing bunion deformity failing conservative care for many years, elected for a bunionectomy. Resorbable screws are an excellent option for fixation in bunion surgery with Tornier RFS Screw, a product manufactured by Bioretec Ltd. Although there are many absorbable materials available for implantation, a combination of Poly-Lactic Acid and Poly-Glycolic Acid may be the best option combining strength and controlled resorption.

ID: WP06
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Syndesmosis Fixation Using ActivaScrew™ in Three Weber C -Type Ankle Fracture Cases

Tero Järvinen M.D., Ph.D.


Three cases where surgeon successfully combined the use of conventional metallic AO-plates and -screws with the biodegradable syndesmosis screw (ActivaScrew™ 4.5 x 70 mm) to fix the ruptured syndesmosis after the Weber C -type ankle fractures.

ID: WP07
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Conclusion Study For Absorbable ActivaPin™ - 50 cases with 2 years of follow-up

Docteur Hubert ROCHE

The study included 50 cases of hallux valgus surgery on 43 women and 7 men. The average age was 56 years and 1 month. Preoperative score (AOFAS Classification) was 48. Postoperatively the average AOFAS score was 92.

ID: WP08
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First Metatarsophalangeal Joint Arthrodesis Using ActivaScrew™ Cannulated

Dr. Nikke Partio, Orthopedic Trauma Surgeon.


The patient was a 58-year-old woman with a hallux valgus deformity on the right extremity with persistent pain and swelling for years. Two bioabsorbable cannulated screws (30 mm and 35 mm) were used. The preoperative AOFAS Hallux Metatarsophalangeal Interphalangeal score was 47. The AOFAS score was 76 at the 12-month visit and remained as 76 at the 24-month follow-up.

ID: WP09
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Fixation of Osteochondritis Dissecans (OCD) Lesions Using ActivaPin™s

Tero Järvinen M.D., Ph.D.

The patient was an 18-year-old male and an active football player with osteochondritis lesion in the medial femoral condyle. This difficult OCD was fixed with 8 ActivaPin™s. ActivaPin™ is very easy and convenient to use in OCD fragment fixation. Self-Locking SL™ feature provides outstanding locking of the material as well as compression at the fracture line that is crucial for small fragment fixation.

ID: WP10
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Fixation of Osteochondritis dissecans (OCD) Using ActivaPin™ and Arthroscopic Pin Applicator

Esa Partio M.D., Ph.D

The patient was a 15 years old sports active male, with diagnosed Osteochondritis dissecans (OCD) in the right knee. Operative treatment of the OCD lesion was decided to do with two ActivaPin™ 2.0 x 30 mm implants. Result of the operation was good and the patient was able to continue his semi-professional sports activities.

ID: WP11
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Fixation of Patella Fracture Using ActivaPin™and ActivaScrew™

Esa Partio M.D., Ph.D.

Patient was an 18 years old sports active male. The fracture of patella occurred while playing badminton due to subluxation of the patella. Main fragment was fixed using one ActivaScrew™ 4.5 mm fully threaded and a loose osteochondral fragment was fixed using two ActivaPin™ 2.0 mm. The patient was able to return to normal sport activities 6 weeks postoperatively.

ID: WP12
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Fixation of the tibial condyle fracture with ActivaScrews™

Prof. Dr. Alexandr Shuginov and Dr. Aleksandr Nikitin Orthopaedic surgeons

The patient is a man, 47 years old, with a car accident trauma. The fracture in the lateral condyle of the left tibia was decided to surgically fix with bioabsorbable ActivaScrew™s. The postoperative period was normal with excellent clinical and radiological results.

ID: WP13
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LCL Reconstruction Using ActivaScrew™ Interference

Tero Järvinen M.D., Ph.D. Professor, Chief Surgeon


The patient was 31-year old healthy female, who had injured her left knee in ultimate fighting-training. A total, grade III, isolated rupture of the lateral collateral ligament (LCL) was suspected based on the clinical examination. Two ActivaScrew™ Interferences were used for the fixation. The patient had experienced no setbacks in her post-op regimen at the 8 months’ follow-up. She had returned to full ultimate fighting (competitive) training before the 6 month follow-up without any symptoms.

ID: WP14
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Patellar Osteochondral Fragment Fixation Using ActivaPin™ - 11 Year-old Child

Juha-Jaakko Sinikumpu M.D., Ph.D. Pediatric Orthopedic Surgeon

The patient was an 11-year old female who fell while bicycling and injured her right knee. In the primarily radiographs a loose bone fragment was seen in the knee joint. The fragment was fixed with three ActivaPin™s. The knee was symptomless, stable and the range of motion (ROM) was normal.

ID: WP15
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ACL Re-Rupture Fixation Using ActivaScrew™ Interference

Tero Järvinen M.D., Ph.D.

The patient was a 29 years old male, who had a left knee trauma and a total ACL rupture six years earlier. ACL re-rupture diagnosis was confirmed by the MRI. Femoral fixation was carried out with ActivaScrew™ Interference screw (8 x 24 mm) and tibial fixation was carried out with ActivaScrew™ Interference screw (9 x 30 mm). The patient was very satisfied with the outcome of the ACL revision surgery and Full ROM was achieved (ROM 0-140).

ID: WP16
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Fixation of Tibial Plateau Fracture Using ActivaScrew™ Cannulated - 11.5-Year-old Child

Dr. Stephane Tercier M.D. Pediatric Trauma Surgeon

The patient was 11.5-year old male, with diagnosed right proximal tibia fracture, type Salter-Harris 3 of the external epiphysis. Operative treatment of the fracture was decided and two ActivaScrew™ Cannulated screws (40x40 mm and 40x35 mm) were fully inserted. Result of the procedure was excellent. The patient could totally return to sport within 6 months.

ID: WP17
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Salter Osteotomy Using ActivaScrew™ Cannulated - 3 Year-old Child

Tero Laine M.D., Ph.D

The patient was a 3 years old child with congenital dislocation of the hip. Patient’s left side hip has been operated 4 months ago using K-wires. The right side hip was now operated with Salter osteotomy using two fully threaded 4.5 mm ActivaScrew™ Cannulated. The ActivaScrew™ Cannulated can be used in the Salter Osteotomy to overcome the problems with the use of K-wires. No migration, pin tract infections or removal operation which makes the use of ActivaScrew™ Cannulated more comfortable to the patients.

ID: WP18
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Humeral Head Reconstruction using ActivaScrew™ and ActivaPin™

Dr. Gábor Skaliczki, M.D. Ph.D, Dr. Kovács, M.D

The patient is a 26-year old male, with a proximal humeral head fracture with a posteriorly dislocated 30 x 35mm fragment in a car accident. Reconstruction of the humeral head was performed with ActicaScrew™ and ActivaPin™. ActivaScrew™ is a suitable tool for intra-articular fixation of large fracture fragments. Additional ActivaPin™ can be used for enhanced rotational stability.

ID: WP19
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Possibilities of Calcaneus Fracture Osteosynthesis with Cannulated PLGA Screws

Linnik S. A., Shuginov A.A., Nikitin A.V.

39 patients with Calcaneus fractures were treated during years 2011-2012, where 70% - patients of young and middle (employable) age. 34 patients were operated, 2 patients withdrew from the operation, 3 patients – conservative treatment after closed reposition of fracture.

The main indication for treatment is the preservation of the Böhler angle as well as the relocation of posterior facet fragments for less than 2 mm. Presence of such co-existing pathologies as peripheral vascular disease, infectious diseases and diabetes are also taken into consideration. The hospital treatment period was 1-2 days before and 3-6 days after the operation.

ID: WP20
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Mini-invasive biodegradable PLGA osteosynthesis in the treatment of children’s distal tibial fractures

N.Yu. Serova, S.O. Nikishov, D.Yu.Basargin, A.M.Lushnikov, S.V. Sidorov, M.K.Tishenko, D. A. Vorobyev - Traumatology department ?Children’s Clinical and Research Institute of Emergency Surgery and Trauma?, Moscow, Russia

36 operations were done on children with fractures in the epiphysis area. Such complications as dislocation of bone fragments, implant migration, fracture union delay, inflammation and stiffness in the damaged joint as well as a local reaction to the implant were not mentioned in a period of follow up study.

ID: WP22
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Biodegradable Implants in Treatment Of Chronic Posttraumatic Anterior Shoulder Instability With Bone Defect of Scapula Articular Process

Vasily V. Monastyrev, Vyacheslav Y. Vasilyev, Marina E. Puseva, Nikolay S. Ponomarenko, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

The aim was to assess the effectiveness and safety of biodegradable implants in the treatment of chronic post-traumatic anterior shoulder instability under conditions of glenoid cavity margin bone defect of more than 20 % of scapula articular surface. The study of using modern biodegradable implants in osteoplastic stabilization of shoulder joint with bone defect more than 20 % of scapula articular surface showed its effectiveness and safety.

ID: WP26
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Biomechanical pull-out test between Synthes LAG screws, Bioretec ActivaScrew™ LAG and Bioretec ActivaScrew™ with porcine fibula

Bioretec Ltd.

The purpose of this study was to investigate and compare the biomechanical pull-out force of metallic screw fixation and bioabsorbable screw fixation of acromioclavicular joint. The test demonstrated that the bioabsorbable 4.5 mm ActivaScrew™ give similar pull-out force in a simulated acromioclavicular joint fixation when compared to metallic 6.5 mm LAG screw. The ActivaScrew™ LAG shows the best results of all the screws in the test. 

ID: WP27
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Bioretec ActivaPin™ and ActivaNail™ material compared to CONMED Smartnail®

Bioretec Ltd.

PLGA, the material used in ActivaNail™ and ActivaPin™ has low crystallinity on contrary to 96L/4D, PLA, which has high crystallinity. Other differences in the SmartNail® are the long absorption time, the possibility of implant capsulation leading to possible increased risk of reinjury and the design of the implant.

ID: WP28
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Fracture of the Greater Tuberosity of the Humerus, Fixation with ActivaScrew™s Cannulated

M.D. Aleksandr Nikinin, Orthopedic Trauma Surgeon.

The patient was a 54-year-old woman with a displaced fracture of the greater tuberosity of the left humerus. The fracture was fixed with two 3.5 mm x 45 mm bioabsorbable ActivaScrew™s Cannulated with partial thread. The course of the postoperative period was normal with excellent clinical and radiologic results.

ID: WP29
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Fixation of the Patella Fracture using ActivaScrew™ Cannulated

M.D. Alexandr Nikitin Orthopedic Trauma Surgeon

61-year-old woman, active with sports, got injured with a displaced patellar fracture. The fracture was fixed with 2 biodegradable ActivaScrew™ Cannulated 4.0 x 50 mm fully threaded screws. After 6 weeks control radiographs showed the correct position of the fragments and consolidation.

ID: WP30
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Bioabsorbtion of Bioretec Activa™ implants

Bioretec Ltd.

Oriented PLGA (poly(lactic-co-glycolic acid) polymer is a very strong and tough material. Therefore it is suitable raw material for manufacturing of bioabsorbable implants. Final bioabsorption takes 1 to 2 years in vivo, depending on implant size, geometry and tissue metabolism conditions at the implantation site.

ID: WP31
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Bioretec Activa™ Biocompatibility Information Package

Bioretec Ltd.

From the chemical point of view medical grade poly L-lactide-co-glycolide copolymer (PLGA) used in Bioretec´s orthopaedics and traumatology products do not contain components, which could negatively affect the biocompatibility of the material. The monomers of PLGA are part of the normal chemistry of mammalian cells.

ID: WP32
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Fixation of physeal fractures with bioabsorbable implants

Bioretec Ltd.

The advantage of the bioabsorbable device fixation in physeal fractures of children is that a second procedure for hardware removal is not required. According to general instruction, crossing the physis with any form of fixation should be avoided, if possible. However, according to literature, if the fixation of physeal fractures by crossing through the growth plate is demanded, fixation with small bioabsorbable pins can be safely done without significant growth disturbance, as the size of the pin remains 3 % or less of the total cross-sectional area of the growth plate.

ID: WP35
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Comparison between ActivaScrew™ and titanium compression screws: biomechanical compressional force and force relaxation after implantation

Bioretec Ltd.

The ActivaScrew™ achieves similar compressional forces as the metal screws. ActivaScrew™ holds the compression better than the metal screw after achieving the stabilized compression level.

ID: WP36
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Physeal Fractures and Bioabsorbable Implants - Literature review

Bioretec Ltd.

Bioretec Research and Development literature review on the physeal fractures with classifications and literature findings.

ID: WP34
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Treatment of medial malleolus fracture in skeletally immature patient with bioabsorbable screws

Dolnák, A., Béder, I., Sýkora, L., Jáger, R., Haas, I. Pediatric Trauma Center, Dpt. of Pediatric Surgery National Institute of Children’s Diseases, Bratislava, Slovakia Pharmacare Slovakia, s.r.o.

Fractures around immature ankle are relative common. In the literature, the incidence is approximately 5% of all skeletal fractures. (58, 68) The physeal growth plate is an important structure and deserves special attention. Complete distal tibia epiphysis closure can be observed between 12-17 year of age. In consideration of this we can find several types of injuries typical for childhood (physeal injuries), adolescent or transition age (Tillaux, Triplane fractures) and subsequently adult-like fractures (bimalleolar, trimalleolar fractures) Keywords bimalleolar fracture, adolescent, surgical treatment, bioabsorbable screw.

ID: WP37
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Bimalleolar ankle fracture fixation of a 13-year-old patient with two ActivaScrew™ LAG bioabsorbable screws.

Pierre Lascombes, Professor, M.D., Ph.D.

13 years old girl presents with a fracture dislocation of the right ankle joint following a gymnastic fall. She was treated with two ActivaScrew™ LAGs. Three months later, the range of motion of the right ankle was
comparable with the left one.

ID: WP38
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RemeOs™ material

Bioretec Ltd.

RemeOs™ implants are made of unique and patented bioresorbable metal alloy constructed from Magnesium, Calcium and Zinc, which are all essential elements of new bone formation in human body. Noteworthily RemeOs™ does not contain any materials foreign to human body like Yttrium, Gadolinium, Neodymium nor any other rare-earth elements (REE).

ID: WP41
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Activa™ material

Bioretec Ltd.

Activa™ implants are orthopaedic implants made of bioabsorbable materials. In the early stages of bone healing, bioabsorbable implants preserve fixation. With the passage of time, the implant gradually absorbs and the stresses are gradually transferred to the healing tissue. The implant absorbs in vivo by hydrolysis into biocompatible absorption products, which are metabolized in the body.

ID: WP40
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Comparison between ActivaScrew™ Interference TCP and Milagro® Advance Interference Screw: Fixation Strength In-vitro

Bioretec Ltd.

In this in-vitro study the fixation strength of the ActivaScrew™ Interference TCP was compared to the Milagro® Advance Interference Screw. In the study pull-out test was performed initially (time zero) and during in-vitro up to 26 weeks. All pull-out tests were carried out in the 37 °C water bath.

ID: WP39
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Articular proximal first metatarsal bone fracture of a 14-year old patient fixed with one ActivaScrew™ LAG bioabsorbable screw.

Pierre Lascombes, Professor, M.D., Ph.D.

A 14 years old boy violently twisted his left foot. The pain was intense and immediate weight-bearing was impossible. ActivaScrew™ LAG 3.5 was inserted to fix the fracture and absence of weight-bearing was six weeks postoperatively. X-rays at three months follow-ups showed an excellent bone union and a proper alignment. The boy was allowed to return to any sports activities like before.

ID: WP42
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Olecranon articular fracture of a 5-year-old patient, fixation with two ActivaScrew™ LAG screws.

Pierre Lascombes, Professor, M.D., Ph.D.

A roller-skating injury without any protection pads, a direct trauma to the left elbow of a 5-year-old boy. The pain was intense and immediate swelling of the elbow was visible.  X-rays demonstrated a rare type of fracture of the olecranon. A longitudinal line through the joint separated the olecranon in two pieces and ended into the coronoid process. The fixation was done with two partially threaded 3.5 mm ActivaScrew™ LAG bioabsorbable screws. The healing went as anticipated, very well. At the three month follow-up, the boy had already returned to all sports activities like before. The fractured bone could continue growing normally without any implant removal operations.

ID: WP43
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