Augmentation of distal radius fracture fixation with coralline hydroxyapatite bone craft substitute

We implanted coralline hydroxyapatite bone graft as a substitute for autoge nous bone graft to support the reduced articular surface of 21 consecutive patients with distal radius fractures treated with external fixation and K- wires. The purpose of this single-cohort retrospective study was to report the outcomes of treatment with this material, complications associated with its use, and its efficacy in supporting the articular surface reduction. E ighteen patients were available for independent evaluation of motion, subje ctive outcome analysis, and final radiographic analysis at an average of 35 months after surgery. Wrist motion averaged 90% of the uninjured wrist and grip strength measured 75% of the uninjured side. Results in 17 of the 18 cases were rated as good or excellent by the criteria of Gartland and Werle y; 12 by the criteria of Green and O'Brien. Seventeen had good or excellent radiographic results by the modified Lidstrom radiographic scoring system. The average DASH functional/symptom score was 90.3 (maximum, 100). Radiogr aphic parameters were restored to an average of 12 mm radial length, 4 degr ees volar tilt, 23 degrees radial inclination, and 0.6 mm positive ulnar va riance;articular reduction was maintained in all patients. A complication r elated to the use of coral was a 0.5 mm prominence of coralline hydroxyapat ite beyond the subchondral line at the radiocarpal joint in 1 patient, whic h was not present an final radiographs. Coralline hydroxyapatite was effect ive at maintaining articular surface reduction when used in combination wit h external fixation and it-wires and had a safety profile comparable to oth er forms of treatment. (J Hand Surg 1999;24A:816-827. Copyright (C) 1999 by the American Society for Surgery of the Hand.).