Calcium phosphate injection technique for treatment of distal radius fracture

Abstract

Abstract Introduction: Distal radius fracture (DRF) is 1 of the common sites of osteoporotic fractures. Bone defects near fractures play an important role in the treatment of unstable distal radius fractures in older patients. To prevent this, bone grafts can be considered, and the most easily available and easy-to-use bone grafting materials are synthetic bone grafts. However, the efficacy of using injectable calcium phosphate (CaP), a synthetic bone substitute graft is controversial in terms of the volume required to provide adequate strength. In the case reports, we focus on the use of CaP in conventional surgery for osteoporotic distal radius fracture. Patient concern: In the first case, an 81-year-old woman presented with right wrist pain after a slip and fall accident. She had a right DRF with osteoporosis. In the second case, a 67-year-old woman presented with left wrist pain after falling. She was found to have a left DRF. Diagnosis: Radiography and computed tomography revealed the DRFs, and bone mineral density indicated osteoporosis. We defined these DRFs were unstable due to loss of position following anatomical reduction and the presence of osteoporosis. Interventions: We performed internal fixation using conventional locking plates. After fixation, a hole was made in the middle of the window of the plate, and CaP was injected through this hole. Outcomes: Six months postoperatively, complete bone union was achieved without subsidence of the distal fragment. Conclusion: This novel CaP injection technique can be a safe and effective technique for the treatment of unstable DRF to prevent malunion.