title: Void filling of tibia compression fracture zones using a novel resorbable nanocrystalline hydroxyapatite paste in combination with a hydroxyapatite ceramic core: first clinical results.
abstract: BACKGROUND
  It is a generally accepted standard surgical practice to fill-in the metaphyseal defect zones resulting from the reduction of tibia compression fractures. The development of various innovative bone substitutes is also currently on the increase.
  
  
  METHODS
  In our prospective study, we used Ostim, a novel resorbable nanocrystalline hydroxyapatite paste, together with Cerabone, a solid hydroxyapatite ceramic, in combination with angularly stable osteosynthesis to treat 24 tibia compression fractures. Types B2 and B3, as well as types C2 and C3 fractures, according to the AO classification, were included in the study.
  
  
  RESULTS
  The mean total range of joint motion in terms of flexion and extension was improved from the immediate postoperative value of 79 +/- 14 degrees to 97 +/- 13 degrees at 6 weeks after surgery, to 109 +/- 16 degrees at 3 months, and finally to 118 +/- 17 degrees at 1 year. In three patients, a delayed wound healing was observed as a local complication.
  
  
  CONCLUSIONS
  The use of the Ostim and Cerabone combination is an effective method in treating tibia compression fractures with large defect zones left after reduction.
authors.affiliation: Surgical Clinic, Division of Traumatology and Reconstructive Surgery, University of Heidelberg, INF 110, Heidelberg 69120, Germany. franz-xaver.huber@med.uni-heidelberg.de
authors.forename: Franz-Xaver
authors.initials: FX
authors.lastname: Huber
authors.forename: Nicholas
authors.initials: N
authors.lastname: McArthur
authors.forename: Joachim
authors.initials: J
authors.lastname: Hillmeier
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Kock
authors.forename: Martin
authors.initials: M
authors.lastname: Baier
authors.forename: Martin
authors.initials: M
authors.lastname: Diwo
authors.forename: Irina
authors.initials: I
authors.lastname: Berger
authors.forename: Peter Jürgen
authors.initials: PJ
authors.lastname: Meeder
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002516:Ceramics / Q000627:therapeutic use; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles / Q000627:therapeutic use*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013977:Tibia / Q000473:pathology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D001843:Bone Cements; D018786:Bone Substitutes; D006882:Hydroxyapatites; C000593119:cerabone