Tricalcium phosphate as a bone graft substitute in trauma: preliminary report

Ceramic tricalcium phosphate (TCP) has been implanted in bony defects in 43 patients following trauma. It is an osteoconductive material that facilitates trabecular bone formation. The average follow-up time was 12 months, with a 6-month minimum. There were 33 fractures in 30 patients and 13 nonunions in 13 patients. Three of the patients with acute fractures were unavailable for follow-up observation. Ninety percent of the fractures and 85% of the nonunions were healed at the time of this review. The resorption of TCP was estimated from the roentgenograms to be approximately 10% per month, with complete resorption occurring in 6-24 months. There were eight complications, five among the 30 fractures and three among the 13 nonunions that were observed later. There were three fractures and two nonunions that failed to heal. There were two fractures that had initially been open and one previously infected nonunion that united but were complicated due to infection. These preliminary results demonstrate TCP's usefulness as a substitute for cancellous bone. This is accompanied by other advantages, including increased patient safety, lack of donor site morbidity, unlimited shelf life and reduced operating time.