Verwendung von nanokristallinem Hydroxyapatit (Ostim®) bei der Versorgung von Radiusfrakturen

Zusammenfassung

Ziel der Untersuchung: Bei Radiusfraktur mit metaphysärer Trümmerzone und Gelenkbeteiligung wird der Einsatz von innovativem Knochenersatzmaterial geprüft. Basismethodik: 11 C 2-, 11 C 3-, 3 A 3-Radiusfrakturen werden mit winkelstabiler palmarer Plattenosteosynthese sowie mit einer Defektauffüllung aus nanokristallinem Hydroxyapatit versorgt. Untersuchungen erfolgen präoperativ, postoperativ nach 4 und 12 Wochen und nach 9–12 Monaten. Ergebnisse: 10,5 ± 1,4 Monate postoperativ bestehen ein dorsopalmarer Neigungswinkel von 8,7 ± 1,8° und ein radioulnarer Neigungswinkel von 18,8 ± 2,9° bei durchschnittlichem Ulnavorschub von 0,6 ± 1,8 mm. Nach der Gartland / Werley-Bewertung werden 10 Behandlungsergebnisse mit „sehr gut”, 12 mit „gut” und 3 mit „mäßig” bewertet. Schlussfolgerung: Mit einer Kombination aus winkelstabiler Plattenosteosynthese und nanokristalliner Hydroxyapatitauffüllung im metaphysären Defektbereich zur Versorgung von A 3-, C 2- und C 3-Radiusfrakturen sind radiologisch und klinisch gute Ergebnisse erzielbar.

Abstract

Aim of the Study: In this study, innovative bone replacement material was tested after complicated metaphyseal radius fractures with the affected joints. Material and Methods: In all, 11 C 2, 11 C 3 and 3 A 3 radius fractures were treated by surgery combining an angularly stable palmar plate osteosynthesis with defect filling using nanocrystalline hydroxyapatite. Examinations were conducted preoperatively and postoperatively after 4 weeks, 12 weeks and 9–12 months. Results: After 10.5 ± 1.4 months, inclination angles of 8.7 ± 1.8° (dorsopalmar) and 18.8 ± 2.9° (radioulnar) were measured at the treated fractures, the ulnar drift was 0.6 ± 1.8 mm. According to the Gartland / Werley scale, 10 therapeutic results were considered „excellent”, 12 „good” and 3 „fair”. Conclusion: An angularly stable plate osteosynthesis with metaphyseal defect filling using nanocrystalline hydroxyapatite for the treatment of A 3, C 2 and C 3 radius fractures showed satisfactory radiological and clinical results.

Radiusfraktur - metaphysärer Defekt - Hydroxyapatit - nanokristallin

radius fracture - methaphyseal defect - hydroxyapatite - nanocrystalline

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