title: A New Injectable Brushite Cement: First Results in Distal Radius and Proximal Tibia Fractures.
abstract: OBJECTIVE
  The restoration of metaphyseal defects remains a challenge for the treating surgeon. Although injectable brushite cements may help to refill bone defects stabilized with internal fixation, human data remains unavailable. The main goal of this prospective multicenter study was to observe the performance of this material in a clinical setting.
  
  
  METHODS
  The study conducted in seven trauma units included closed metaphyseal distal radius and proximal tibia fractures with bone defects, stabilized with internal fixation and subsequent filling with brushite cement. At 6- and 12-month follow-ups, patient satisfaction (visual analog scale [VAS]) was recorded, as well as complications.
  
  
  RESULTS
  Thirty-eight proximal tibia fractures and 37 patients with distal radius fractures were included. Overall patient satisfaction with the treatment was high (mean VAS = 92 and 91 for proximal tibia and distal radius, respectively), despite the loss of reduction being described in 11% of proximal tibia and 24% of distal radius fractures; the majority of them included severe fracture types. Radiological evaluation showed postoperative cement leakage in 20 cases, where the majority occurred at the distal radius (n = 15). In 13 distal radius fractures, the leakage was resorbed by the final examination.
  
  
  CONCLUSIONS
  The tested material showed good outcome in the majority of patients and adequate resorption characteristics, even in the case of extravasation. Stable internal fixation, sufficient bone quality, and no contact between the cement and joint are essential requirements for chronOS Inject, which can be considered as an alternative to existing augmentation materials.
authors.affiliation: Davos Hospital, Davos Platz, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Ryf
authors.affiliation: AO Clinical Investigation and Documentation, Dübendorf, Switzerland. sabine.goldhahn@aofoundation.org.|AO Clinical Investigation and Documentation, Stettbachstrasse 6, 8600, Dübendorf, Switzerland. sabine.goldhahn@aofoundation.org.
authors.forename: Sabine
authors.initials: S
authors.lastname: Goldhahn
authors.affiliation: Springs Parklands Clinic, Department of Orthopedics, Wits University Johannesburg, Johannesburg, South Africa.
authors.forename: Marek
authors.initials: M
authors.lastname: Radziejowski
authors.affiliation: Department for Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Blauth
authors.affiliation: AO Clinical Investigation and Documentation, Dübendorf, Switzerland.
authors.forename: Beate
authors.initials: B
authors.lastname: Hanson
keywords: Bone cement; Bone substitutes; Radius fractures; Tibial fractures
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