Abstract | BACKGROUND: Displaced intra-articular calcaneal fractures may have a central cancellous bone defect area. We hypothesized that human demineralized bone matrix (DBM) calcium sulfate (CaSO(4)) might act as a reasonable alternative to autograft in calcaneal fractures. When combined with antibiotic powder, this bone graft substitute also may act as a local antibiotic delivery device. This is the first clinical study evaluating bone healing and complications associated with DBM- calcium sulfate bone graft substitute in the treatment of displaced intra-articular calcaneal fractures with a central cancellous bone defect. METHODS: Over a 29-month period, 33 displaced intra-articular calcaneal fractures with central cancellous defects were treated with open reduction and internal fixation (ORIF) and grafting with vancomycin/DBM- calcium sulfate bone graft substitute. Eleven fractures without bone defects were treated with ORIF only. Patient demographics, medical history, and CT fracture classification were recorded. Postoperatively, fractures were monitored every 2 weeks for healing and complications. RESULTS: The mean time to union was 8.2 weeks in the grafted, while the control group mean time to union was 10.4 weeks (p = 0.0117). Wound problems occurred in five (15%) of the 33 patients with grafting, all in type III fractures with severe soft-tissue swelling, and included two minor wound healing delays, and three serious wound problems. At a mean followup time of 22.4 months, no DBM- calcium sulfate grafted calcaneus demonstrated evidence of osteomyelitis. CONCLUSIONS: This is the first study examining human DBM- calcium sulfate bone graft substitute to treat displaced intra-articular calcaneal fractures. Based on these initial data, human DBM- calcium sulfate acted as an acceptable and safe autograft alternative in displaced intra-articular calcaneal fractures with moderate (5 cc to 10 cc) central cancellous bone defects.
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Authors | Christopher Bibbo, Dipak V Patel |
Journal | Foot & ankle international
(Foot Ankle Int)
Vol. 27
Issue 7
Pg. 487-93
(Jul 2006)
ISSN: 1071-1007 [Print] United States |
PMID | 16842714
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Bone Substitutes
- Vancomycin
- Calcium Sulfate
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Topics |
- Adolescent
- Adult
- Anti-Bacterial Agents
(therapeutic use)
- Bone Matrix
(transplantation)
- Bone Substitutes
(therapeutic use)
- Bone Transplantation
(methods)
- Calcaneus
(injuries, surgery)
- Calcium Sulfate
(therapeutic use)
- Female
- Fracture Healing
(drug effects)
- Fractures, Bone
(therapy)
- Humans
- Male
- Middle Aged
- Postoperative Complications
- Prospective Studies
- Surgical Wound Infection
(etiology, prevention & control)
- Time Factors
- Treatment Outcome
- Vancomycin
(therapeutic use)
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