[Treatment of bony fibrous dysplasia with calcium-phosphate cement: a case report].
We report successful use of calcium-phosphate cement for the treatment of benign polyostotic fibrous dysplasia in a patient who had undergone several unsuccessful surgical procedures. As no autologous bone was available for further grafting, we used a bone substitute to fill two defects, one in the upper part of the humerus and the other in the radial shaft. The curettage cavity was filled with calcium-phosphate hydroxyapatite cement. The type of bone substitute was chosen for its specific properties: mineral structure similar to bone, microporosity, resistance to compression between cancellous and cortical bone, composition favorable to exchange between the crystals and the interstitial medium. Outcome was favorable early for the shoulder and later for the forearm after surgery for recurrence. Due to progress in the development of diphosphonates, indications for surgery for fibrous dysplasia have been reduced. There remains a risk of recurrence and incomplete results but bone substitute filling can be a useful alternative to autografts and complementary fixation. Calcium-phosphate cement is an easy-to-use paste-like product with interesting physicochemical and biological properties making it a leading choice for bone substitution.
Service de Chirurgie Orthopédique, Centre Hospitalier, BP 9, 17301 Rochefort-sur-Mer Cedex. p.liverneaux@tiscali.fr
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D001843:Bone Cements / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome
D001843:Bone Cements; D002130:Calcium Phosphates