[Alloplastic cancellous bone replacement and fibrin glue in hand surgery].
BACKGROUND
Alloplastic replacement of cancellous bone is being increasingly used in the clinical setting. The use in hand surgery, however, is only sparsely documented.


METHODS
We report about the use of micro- and macroporous biphasic calicium phosphate granulate (Tricos (®)) in combination with fibrin sealant (Tissucol (®)) in six patients undergoing surgery of the hand involving cancellous bone deficits. The indications ranged from carpal stabilisation to DIP athrodesis. Follow-up time was up to 15 months.


RESULTS
Because cancellous bone harvesting could be avoided, morbidity and the extent of surgery could be reduced in all patients. Healing was uneventful and the clinical course as documented by X-ray controls, toleration of physiotherapeutic exercises and stability was analogous to that of conventional surgery involving cancellous bone grafting.


CONCLUSIONS
These first results indicate that alloplastic replacement of spongiosa grafts, especially by micro- and macroporous biphasic calcium phosphate granulate can possibly be successfully used in surgery of the hand. The extent of bony remodelling still needs to be determined by further examination.
Wolter
T P
TP
Klinik für Plastische Chirurgie, Hand- u. Verbrennungschirurgie, Universitätsklinikum der Medizinischen Fakultät der RWTH Aachen. twolter@ukaachen.de
Fuchs
P
P
Pallua
N
N
D000328:Adult; D000369:Aged, 80 and over; D000673:Amputation, Traumatic / Q000000981:diagnostic imaging / Q000601:surgery; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D002812:Chondroma / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D050278:Finger Phalanges / Q000293:injuries* / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography
D018786:Bone Substitutes; D002130:Calcium Phosphates; D015718:Fibrin Tissue Adhesive; C549165:TricOs T