title: Effect of calcium phosphate bone cement augmentation on volar plate fixation of unstable distal radial fractures in the elderly.
abstract: BACKGROUND
  Calcium phosphate bone cement increases the stability of implant-bone constructs in patients with an osteoporotic fracture. The purpose of this randomized study was to determine whether augmentation of volar locking plate fixation with calcium phosphate bone cement has any benefit over volar locking plate fixation alone in patients older than sixty-five years of age who have an unstable distal radial fracture.
  
  
  METHODS
  Forty-eight patients (fifty unstable distal radial fractures) were recruited for this study. The mean patient age was seventy-three years. Surgical procedures were randomized between volar locking plate fixation alone (Group 1) and volar locking plate fixation with injection of calcium phosphate bone cement (Group 2). The patients were assessed clinically at three and twelve months postoperatively. Clinical assessments included determinations of grip strength, wrist motion, wrist pain, modified Mayo wrist scores, and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiographic evaluations were performed immediately postoperatively and at one year following surgery. The adequacy of the reduction was assessed by measuring radial inclination, volar angulation, and ulnar variance.
  
  
  RESULTS
  The two groups were comparable with regard to age, sex, fracture type, injury mechanism, and bone mineral density. No significant differences were observed between the groups with regard to the clinical outcomes at the three or twelve-month follow-up examination. No significant intergroup differences in radiographic outcomes were observed immediately after surgery or at the one-year follow-up visit. Furthermore, no complication-related differences were observed, and there were no nonunions.
  
  
  CONCLUSIONS
  Augmentation of metaphyseal defects with calcium phosphate bone cement after volar locking plate fixation offered no benefit over volar locking plate fixation alone in elderly patients with an unstable distal radial fracture.
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea. kimjk@ewha.ac.kr
authors.forename: Jae Kwang
authors.initials: JK
authors.lastname: Kim
authors.forename: Young Do
authors.initials: YD
authors.lastname: Koh
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Kook
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000494:pharmacology*; D001860:Bone Plates; D002130:Calcium Phosphates / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D053401:Palmar Plate / Q000601:surgery*; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D001843:Bone Cements; D002130:Calcium Phosphates; C020243:calcium phosphate