Sudo Yoshito, Nishida Yoshihiro, Nakashima Hiroatsu, Arai Tetsuya, Takatsu Tetsuro
Department of Orthopaedic Surgery, Gifu Prefectural Tajimi Hospital, Gifu 507-8522, Japan.
Department of Rehabilitation Medicine, Nagoya University Hospital, Nagoya 466-8550, Japan.
Medicina (Kaunas). 2023 Dec 19;60(1):1. doi: 10.3390/medicina60010001.
Postoperative loss of correction is a concern in cases of distal radius fracture with bone loss after surgery. The purpose of this study was to evaluate the usefulness of a β-tricalcium phosphate (β-TCP) with unidirectional pore structure (Affinos: Kuraray Co., Ltd, Tokyo, Japan) with internal fixation in patients with bone defects during the correction of distal radius fractures. Thirty-nine patients (40 radii) treated between 2016 and August 2020 were included in the study. There were 8 males and 31 females; the mean age was 70.9 (32-88). The mean postoperative observation period was 14.6 (3.4-24) months. The bone defect that occurred in the surgery was filled with Affinos and fixed with a locking plate. Radial inclination (RI), volar tilt (VT), and ulnar variance (UV) were evaluated after the operation and at the final observation. The start of absorption and the completion of replacement to the host bone of Affinos were also evaluated. There were no complications associated with grafts of Affinos. The mean time of translucent findings around artificial bone was 1.85 (0.5-6) months, and that of complete resorption was 10.6 (1.5-16.5) months after surgery. The mean RI was 21.82° after surgery and 21.16° at final observation. The mean VT was 8.54° after surgery and 8.50° at final observation. The mean UV was -0.3 mm after surgery and 0.5 mm at final observation. Affinos was resorbed relatively early, and host bone formation was observed. Filling of unidirectional pore structure β-TCP with internal fixation showed favorable outcomes in the surgery of distal radius fractures with bone defects.
术后矫正丢失是桡骨远端骨折术后出现骨缺损病例中的一个问题。本研究的目的是评估具有单向孔隙结构的β-磷酸三钙(β-TCP,商品名:Affinos,可乐丽株式会社,东京,日本)在桡骨远端骨折矫正过程中对伴有骨缺损患者进行内固定时的有效性。本研究纳入了2016年至2020年8月期间治疗的39例患者(40侧桡骨)。其中男性8例,女性31例;平均年龄为70.9岁(32 - 88岁)。术后平均观察期为14.6个月(3.4 - 24个月)。手术中出现的骨缺损用Affinos填充并用锁定钢板固定。术后及末次观察时评估桡骨倾斜度(RI)、掌倾角(VT)和尺骨变异(UV)。还评估了Affinos的吸收开始时间以及向宿主骨替代的完成情况。未出现与Affinos移植相关的并发症。人工骨周围出现半透明表现的平均时间为术后1.85个月(0.5 - 6个月),完全吸收的平均时间为术后10.6个月(1.5 - 16.5个月)。术后平均RI为21.82°,末次观察时为21.16°。术后平均VT为8.54°,末次观察时为8.50°。术后平均UV为 - 0.3 mm,末次观察时为0.5 mm。Affinos吸收相对较早,并观察到宿主骨形成。采用单向孔隙结构β-TCP内固定填充在伴有骨缺损的桡骨远端骨折手术中显示出良好的效果。