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Injectable Calcium Phosphate Cement as an Adjunct to Internal Fixation for Comminuted Distal Radius Fractures.
Mario G. Solari, Matt Hussey, W.P. Andrew Lee, Ronit Wollstein
University of Pittsburgh
2010-04-05
Presenter: Mario G. Solari MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Hand
Introduction:
Distal radius fracture alignment and stabilization can be a surgical challenge in the face of comminution and bone loss. The current standard of care for such cases calls for autologous bone grafting. We describe a technique using a calcium phosphate bone cement as an adjunct to internal fixation. The technique eliminates the need for autologous bone grafting and the associated donor site morbidity. This bone graft substitute is biocompatible, osteoconductive, and sets quickly with an isotherimic reaction.
Methods:
All consecutive severely comminuted distal radius fractures treated by the senior author over a period of 30 months using were reviewed. 36 patients (17 females and 19 males with an average age of 50.7 +/-15.9) met criteria. Charts were retrospectively reviewed for surgical complications including infection, malunion , and non union. Radiographic measurements were followed over time.
Results:
There was one pin site infection (2.8%), one non-union (2.8%), and one case of CRPS (2.8%). Changes in radiologic parameters over time, as well as matched-controls are being evaluated.
Discussion:
In our case series, the use of bone cement eliminated the need for primary autologous bone grafting. Preliminary data suggests that no adverse outcome can be directly linked to the bone cement. The use of bone cement as an adjunct to plate fixation of distal radius fractures is safe and allows for easier reduction and retention of reduction at the time of surgery.
