Autogenous bone grafting, used to repair bone defects, is limited and the donor site can experience complications. Compared to autogenous bone graft, artificial bones have different porosity, which might make them suitable alternatives to bone grafts. Here, two porous biphasic calcium phosphate bone substitutes, namely Bicera™ and Triosite™, are used in an animal study and clinical practice to find a suitable porosity for implantation. Bicera™ and Triosite™ consist of 60 wt% hydroxyapatite and 40 wt% β-tricalcium phosphate, with the porosity of Bicera™ (82%) being higher than that of Triosite™ (70%). In the animal study, the implantation procedure was carried out on twenty-four female New Zealand rabbits. 12 weeks after implantation, the new bones were well infiltrated into the Bicera™ and Triosite™ bone grafts. In the clinical study, patients with comminuted fracture, fracture nonunion, or arthrodesis were included in the study of bone substitution with Bicera™. 27 patients underwent fracture fixation treatment. Bone healing of 22.22% (6/27) of patients happened within 3 months after the surgery, and that of 66.67% (18/27) of patients happened within 6 months. These results reveal that Bicera™ has good incorporation with host bone, and that new bone is able to grow within the porous structure, giving it high potential in the treatment of bone defects.

Background Triangular fibrocartilage complex (TFCC) has become an interest over the last few decades, discovering its understanding in anatomy, pathomechanism, biomechanics, and management in treatments. Currently, TFCC does not have a golden standard procedure, and not one surgical procedure is superior to the other. This study is to evaluate the comparative outcomes in TFCC patients that underwent either in all-inside arthroscopic suture anchors or the arthroscopic transosseous suture technique. Method From 2017 to 2019, 30 patients were analyzed. Eight patients were in an arthroscopic transosseous group and 22 patients were in an all-inside arthroscopic group. Comparison between patients’ flexion and extension range of motion (ROM), grip strength, and visual analog pain scale (VAS) preoperative and six-month follow-up were analyzed. Result There were significant increases in flexion ROM, extension ROM, and VAS between preoperative and postoperative in all-inside arthroscopic and arthroscopic transosseous. Only the all-inside arthroscopic group had a significant increase in grip strength. Postoperative flexion ROM had a significant difference between all-inside arthroscopic and arthroscopic transosseous. Conclusion Both the all-inside arthroscopic suture anchor technique and the arthroscopic transosseous suture technique are appropriate treatments to treat patients with TFCC. Both procedures have achieved the ultimate goal of improved longevity and optimal function. Level of evidence Level III; retrospective comparative cohort study.

BACKGROUND Isolated capitate fractures are rare carpal fractures. Following high-energy injuries, capitate fractures are usually associated with other carpal fractures or ligament injuries. The management of capitate fractures depends on the fracture pattern. Here, we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation, with a 6-year follow-up. To the best of our knowledge, this fracture pattern and surgical management have not been previously reported. CASE SUMMARY A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident. Radiography showed a distal capitate fracture with carpometacarpal joint incongruence. Computed tomography (CT) revealed a distal capitate fracture with carpometacarpal joint dislocation. The distal fragment was rotated by 90° in the sagittal plane, and an oblique shearing fracture pattern was noted. Open reduction and internal fixation (ORIF) with a locking plate were performed using the dorsal approach. The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture, and the Disabilities of the Arm, Shoulder, and Hand and visual analog scale scores were significantly improved. CONCLUSION CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation. ORIF using a locking plate are possible.