title: The mineralized collagen for the reconstruction of intra-articular calcaneal fractures with trabecular defects.
abstract: BACKGROUND
  In cases of severe subversion of the morphology of calcaneal fractures with trabecular defects, bone graft is often necessary to provide a mechanical buttress. The mineralized collagen (MC) is a novel bone substitute that is developed by biomimetic synthesis strategy that mimics the extracellular matrix (ECM) of natural bone in structure and chemical composition. It can avoid donor site morbidity and complications associated with harvesting autologous bone graft.
  
  
  OBJECTIVE
  In this study, we conducted a retrospective matched-pair analysis to assess the clinical and radiological performances of MC as a bone graft substitute in intra-articular calcaneal fractures with trabecular defects.
  
  
  METHODS
  24 pairs of intra-articular calcaneal fractures with trabecular defects were treated with open reduction, internal fixation, and grafting either with MC or autograft. Patient demographics, medical history, and CT fracture classification were matched. Fractures were monitored 6 weeks, 12 weeks, 6 months, and 1 year postoperatively for healing and postoperative complications and results were analyzed.
  
  
  RESULTS
  All patients had follow-up at a minimum of 12 months after surgery with a mean follow-up time of 17 months. All fractures were healed; there were no significant differences in the meantime to union and clinical between the two groups. The radiographic evaluation confirmed that a significant improvement in the mean Böhler's angle, Gissane's angle and the calcaneus height was observed in all patients in both treatment groups. A total of 29% (7/24) of patients suffered from harvest-site morbidity at 12 months in the autograft group. In contrast, all patients were free from postoperative local complications in the iliac region and no patient developed adverse reactions attributable to MC in the MC group.
  
  
  CONCLUSIONS
  These results justify and favor the use of MC as a good autograft alternative in displaced intra-articular calcaneal fractures with trabecular defects.
authors.affiliation: Department of Orthopedics; Hubei Xiangyang Central Hospital; Xiangyang, PR China.
authors.forename: Kai
authors.initials: K
authors.lastname: Lian
authors.affiliation: Department of Orthopedics; Hubei Xiangyang Central Hospital; Xiangyang, PR China.
authors.forename: Hong
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Orthopedics; Union Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan, PR China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Guo
authors.affiliation: School of Materials Science and Engineering; Tsinghua University; Beijing, PR China.
authors.forename: Fuzhai
authors.initials: F
authors.lastname: Cui
authors.affiliation: School of Materials Science and Engineering; Tsinghua University; Beijing, PR China.
authors.forename: Zhiye
authors.initials: Z
authors.lastname: Qiu
authors.affiliation: Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan, PR China.
authors.forename: Shuyun
authors.initials: S
authors.lastname: Xu
mesh_terms: D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D040761:Biomimetic Materials / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D003094:Collagen / Q000627:therapeutic use*; D005109:Extracellular Matrix / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D003094:Collagen
keywords: autograft alternative; bone substitute; calcaneal fracture; mineralized collagen; trabecular defect