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The Use of Bone Graft Substitute in Hand Surgery

View Article: PubMed Central - PubMed

ABSTRACT

Bone defects are a very common problem in hand surgery, occurring in bone tumor surgery, in complicated fractures, and in wrist surgery. Bone substitutes may be used instead of autologous bone graft to avoid donor site morbidity. In this article, we will review our experience with the use of Cerament bone void filler (Bonesupport, Lund, Sweden) in elective and trauma hand surgery. A prospective clinical study was conducted with 16 patients treated with this bone graft substitute in our department over a period of 3.5 years. Twelve patients (2 female, 10 male; with an average age of 42.42 years) with monostoic enchondroma of the phalanges were treated and 4 patients (1 female, 3 male; with an average age of 55.25 years) with complicated metacarpal fractures with bone defect. Data such as postoperative course with rating of pain, postoperative complications, functional outcome assessment at 1, 2, 3, 6 months, time to complete remodeling were registered. Postoperative redness and swelling after bone graft substitute use was noticed in 7 patients with enchondroma surgery due to the thin soft-tissue envelope of the fingers. Excellent total active motion of the involved digit was noticed in 10 of 12 enchondroma patients and in all 4 fracture patients at 2-month follow-up. In summary, satisfying results are described, making the use of injectable bone graft substitute in the surgical treatment of enchondromas, as well as in trauma hand surgery a good choice.

No MeSH data available.


Related in: MedlinePlus

A dorsal approach was used (A) and initially the reduction of the fracture with placement of plate and screw followed (B). After the completion of the osteosynthesis, Ceramemt was injected into the defect zone (C). Intraoperative x-ray after open reduction and plate screw osteosynthesis, with Cerament, to treat this subcapital fifth metacarpal defect fracture.
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Figure 2: A dorsal approach was used (A) and initially the reduction of the fracture with placement of plate and screw followed (B). After the completion of the osteosynthesis, Ceramemt was injected into the defect zone (C). Intraoperative x-ray after open reduction and plate screw osteosynthesis, with Cerament, to treat this subcapital fifth metacarpal defect fracture.

Mentions: In patients with metacarpal fractures, a dorsal approach was used. First, reduction of the fracture was performed, followed by the placement of plate and screws. Cerament was injected into the defect zone and, if necessary, a compound osteosynthesis was performed by inserting additional screws into the bonded Cerament. Afterward, the periosteum and interosseous muscle fascia were closed with sutures (Fig. 2). Postoperatively, a wrist splint without finger support was applied for 4 weeks and in these cases physiotherapy and lymphatic drainage started on the first postoperative day. After completion of the osteosynthesis, the postoperative course was evaluated.


The Use of Bone Graft Substitute in Hand Surgery
A dorsal approach was used (A) and initially the reduction of the fracture with placement of plate and screw followed (B). After the completion of the osteosynthesis, Ceramemt was injected into the defect zone (C). Intraoperative x-ray after open reduction and plate screw osteosynthesis, with Cerament, to treat this subcapital fifth metacarpal defect fracture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998432&req=5

Figure 2: A dorsal approach was used (A) and initially the reduction of the fracture with placement of plate and screw followed (B). After the completion of the osteosynthesis, Ceramemt was injected into the defect zone (C). Intraoperative x-ray after open reduction and plate screw osteosynthesis, with Cerament, to treat this subcapital fifth metacarpal defect fracture.
Mentions: In patients with metacarpal fractures, a dorsal approach was used. First, reduction of the fracture was performed, followed by the placement of plate and screws. Cerament was injected into the defect zone and, if necessary, a compound osteosynthesis was performed by inserting additional screws into the bonded Cerament. Afterward, the periosteum and interosseous muscle fascia were closed with sutures (Fig. 2). Postoperatively, a wrist splint without finger support was applied for 4 weeks and in these cases physiotherapy and lymphatic drainage started on the first postoperative day. After completion of the osteosynthesis, the postoperative course was evaluated.

View Article: PubMed Central - PubMed

ABSTRACT

Bone defects are a very common problem in hand surgery, occurring in bone tumor surgery, in complicated fractures, and in wrist surgery. Bone substitutes may be used instead of autologous bone graft to avoid donor site morbidity. In this article, we will review our experience with the use of Cerament bone void filler (Bonesupport, Lund, Sweden) in elective and trauma hand surgery. A prospective clinical study was conducted with 16 patients treated with this bone graft substitute in our department over a period of 3.5 years. Twelve patients (2 female, 10 male; with an average age of 42.42 years) with monostoic enchondroma of the phalanges were treated and 4 patients (1 female, 3 male; with an average age of 55.25 years) with complicated metacarpal fractures with bone defect. Data such as postoperative course with rating of pain, postoperative complications, functional outcome assessment at 1, 2, 3, 6 months, time to complete remodeling were registered. Postoperative redness and swelling after bone graft substitute use was noticed in 7 patients with enchondroma surgery due to the thin soft-tissue envelope of the fingers. Excellent total active motion of the involved digit was noticed in 10 of 12 enchondroma patients and in all 4 fracture patients at 2-month follow-up. In summary, satisfying results are described, making the use of injectable bone graft substitute in the surgical treatment of enchondromas, as well as in trauma hand surgery a good choice.

No MeSH data available.


Related in: MedlinePlus