Open Reduction and Palmar Plate-Osteosynthesis in Combination with a Nanocrystalline Hydroxyapatite Spacer in the Treatment of Comminuted Fractures of the Distal Radius

Abstract

In a prospective study, we used the nanocrystalline hydroxyapatite paste Ostim (Osartis, Obernburg, Germany) in combination with a palmar plate to treat comminuted radius fractures with a metaphyseal and articular component in order to examine the clinical use of Ostim as a bone substitute. Twenty-one patients with 22 radius fractures of AO types C2 and C3 were included in the study. The measurements, taken 10.2+/-1.3 months after the initial treatment, revealed a dorsopalmar tilt of 8.8+/-3.7 degrees , a radioulnar inclination of 18.8+/-2.8 degrees and an ulnar variance of 0.8+/-1.8mm. According to the Gartland and Werley evaluation, eight of the treated fractures attained an excellent, 11 a good and the remaining three a fair result. The study demonstrates that Ostim, in combination with angularly stable osteosynthesis, can be used as an acceptable bone substitute for the treatment of type C2 and C3 radial fractures.

Distal Radius Fracture Management in Elderly Patients: A Literature Review

“…The authors recommend bone cement for augmentation of dorsal bone defects. 39 Less encouraging results were observed in a randomized study of 18 patients (mean age, 73 y). Resorbable bone cement (Osteogenics Inc., Lubbock, TX) was compared with K-wire fixation with significant dorsal angulation and grip strength worsening in the bone-cemented group at a follow-up of 26 weeks (p Ͻ .02).…”

Nanodimensional and Nanocrystalline Calcium Orthophosphates

“…Ostim® can be used in metaphyseal fractures and cysts, alveolar ridge augmentation, acetabulum reconstruction and periprosthetic fractures during hip prosthesis exchange operations, osteotomies, filling cages in spinal column surgery, etc. [609][610][611][612][613][614][615][616][617][618][619][620][621][622]. It might be incorporated into bones and a new bone formation is visible after only three months [623].…”

Nanotechnology

“…A series of fractures of the distal radius showed this to be an acceptable substitute for bone graft in metaphyseal defects. 31 A further series by the same group showed similarly encouraging results when it was used to treat metaphyseal defects in fractures of the tibial plateau. 32 Nanocomposite scaffolds composed of type I collagen and nanostructured HA are currently being used in the treatment of osteochondral defects of the knee.…”