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KMID : 0922220110110010036
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Journal of the Korean Musculoskeletal Transplantation Society
2011 Volume.11 No. 1 p.36 ~ p.41
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The Usefulness of Hydroxyapatite Bone Transplantation in Treatment of Metaphyseal fracture with Bone defect
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Kang Hong-Je
Kim Tae-Kyun
Kweon Seok-Hyen
Shim Dae-Moo
Lee Seong-In
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Abstract
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Purpose: In the case of metaphyseal fracture, delayed union and nonunion is known as uncommon due to the abundant blood flow to the fracture sites. However, since the metaphysis is lined with spongy tissues and frequent bone defect formation follows due to thin cortical layer, delayed union and nonunion has become a frequent event. Therefore, we conducted this study to research on the feasibility of using hydroxyapatite as graft extenders in fracture patients accompanied by metaphyseal bone defect formation.
Materials and Methods: The study was conducted from August of 2004 to July of 2007 on 14 test subjects who suffered form metaphyseal fracture accompanied by bone defect formation. 11 male and 5 female test subjects participated in the study, and their average age was 57 (age ranging from 25~82). Test subjects did have different fracture sites: 1 proximal femur fracture, 4 distal femur fractures, 8 proximal tibia fractures and 3 distal tibia Fracture. Only hydroxyapatite bone transplantations were conducted on the different tests subjects. Average observation period after the surgery was 15.3 months (in the range of 12~24 months). X-rays were taken to observe healing processes and occurrence of side effects.
Results: Open reduction and plate fixation have been conducted on the 14 cases out of 16. Intramedullary Nailing procedure has been conducted on 2 of the patients. 15 cases out 16 showed normal union, while only one showed nonunion. While holding no statistical significances at all, faster chondroplasia was affected by youngness of a patient, degree of bone defect and metaphyseal fractures near knee joints. No side effects from using hydroxyapatite have been observed.
Conslusion: Use of hydroxyapatite in patients suffering from metaphyseal fracture accompanied by bone defect can be considered an effective treatment replacing autograft. Donor site complications can be avoided using hydroxyapatite transplantation and secondary delayed union and nonunion can also be prevented.
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KEYWORD
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Metaphyseal fracture, Hydroxyapatite, Bone transplantation
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