A New Injectable Brushite Cement: First Results in Distal Radius and Proximal Tibia Fractures.

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Trauma reconstruction

Background:

• Metaphyseal bone defects present significant challenges in orthopedic surgery.
• Injectable brushite cements offer potential for bone defect augmentation but lack human clinical data.

Purpose of the Study:

• To evaluate the clinical performance of injectable brushite cement in metaphyseal bone defects.
• To assess patient satisfaction and complications associated with this novel augmentation material.

Main Methods:

• Prospective, multicenter study involving seven trauma units.
• Included patients with closed metaphyseal distal radius and proximal tibia fractures with bone defects.
• Fractures were stabilized with internal fixation followed by brushite cement injection; 6- and 12-month follow-ups recorded patient satisfaction (visual analog scale [VAS]) and complications.

Main Results:

• 38 proximal tibia and 37 distal radius fractures were treated.
• High patient satisfaction reported (mean VAS = 92 for tibia, 91 for radius).
• Loss of reduction occurred in 11% (tibia) and 24% (radius) of cases, primarily severe fractures. Postoperative cement leakage occurred in 20 cases (15 distal radius), with resorption noted in 13 distal radius fractures.

Conclusions:

• Injectable brushite cement shows good outcomes and resorption characteristics, even with extravasation.
• Essential requirements include stable internal fixation, adequate bone quality, and avoiding joint contact.
• This cement can be considered a valuable alternative to existing bone augmentation materials.