Unidirectional Porous β-Tricalcium Phosphate: A New Bone Filling Substitute for Treatment of Distal Radius Fracture in the Elderly Population

J Hand Surg Asian Pac Vol. 2020 Mar;25(1):59-66. doi: 10.1142/S2424835520500083.

Abstract

Background: A new beta-tricalcium phosphate with unidirectional pore structure (UDPTCP), Affinos® (Kurray, Okayama, Japan), has been in clinical use since 2015. To date, there have been only a few clinical studies using this material. We report here the first clinical study for distal radial fracture in the elderly population treated with UDPTCP. Methods: Consecutive patients aged 65 years or older with dorsally displaced unstable fracture of the distal radius (n = 36) were treated operatively in our department. Following reduction of the fracture site, a 7 mm size cube of UDPTCP was placed in the gap of the bony defect and the fracture stabilized with mono-axial or poly-axial type locking plates and screws. Remodeling of the UDPTCP was evaluated by plain radiograph and clinical outcomes were also assessed. Results: UDPTCP was significantly resorbed at 2 months after surgery, both at the center and periphery of the material. Complications were only observed in the post-operative period. Significant correction loss of radial alignment was seen in patients stabilized with poly-axial locking plate. The clinical outcome in all cases was excellent. Conclusions: Block UDPTCP is a safe and convenient material for the treatment of distal radius fracture and is replaced within a suitable time period after grafting into the fracture site. UDPTCP and stable internal fixation is therefore a reliable strategy for restoring and preserving anatomical position, especially in the elderly population.

Keywords: Beta-tricalcium phosphate; Bone graft substitute; Distal radius fracture; Elderly population; Open reduction and internal fixation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Plates
  • Bone Remodeling
  • Bone Resorption / diagnostic imaging
  • Bone Screws
  • Bone Substitutes / therapeutic use*
  • Calcium Phosphates / therapeutic use*
  • Disability Evaluation
  • Female
  • Fracture Fixation, Internal
  • Humans
  • Male
  • Open Fracture Reduction
  • Radiography
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / surgery*

Substances

  • Bone Substitutes
  • Calcium Phosphates
  • beta-tricalcium phosphate