The Use of Calcium Phosphate for Defect Augmentation in Tibial Plateau Fractures
Metaphyseal fractures like Tibial plateau fracture are often associated with bone defects and subchondral voids which need to be filled along with fixation of the fractures. Autologous bone grafting was considered as the ‘Gold Standard’ in filling such bone defect but the associated complications had lead the surgeons to seek alternative options. Calcium Phosphate compounds are highly biocompatible bone substitutes and can be used effectively and safely in Tibial Plateau fractures as an alternative to the autologous bone grafting.
The objective of this study was to determine the outcome of Calcium Phosphate used in maintaining an anatomical reduction in tibial plateau fractures with bony defect requiring augmentation. The Outcome was determined in terms of fracture union and articular subsidence (collapse of articular surface post-operatively).
Total 40 patients, 18 to 50 years of age, meeting
the inclusion criteria, were admitted through the Accident and Emergency department of Mayo Hospital and prepared for surgery. Calcium phosphate bone graft substitute, TCH®, a biphasic ceramic containing hydroxyapatite and tricalcium phosphate, was arranged preoperatively. Open reduction and internal fixation of proximal tibial fracture was done by a single surgeon and quantity of Bone Graft Substitute was determined preoperatively by the surgeon. Thirty seven patients out of 40 (92.5%) achieved complete union at the end of 24 weeks and only 4 patients (10%) developed articular subsidence at the operated site. The authors concluded that the bioresorbable Calcium Phosphate materials such as biphasic calcium phosphate ceramic, appears to be a good choice for the treatment of sub-articular defects in tibial plateau fractures. Therefore, it can be used safely and efficiently as an alternative to the conventionally used autologous bone graft in such fractures.
Key Words: Calcium Phosphate, defect augmentation, tibial plateau fractures.
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