Calcium phosphate bone cement and metaphyseal ­corrective osteotomies in the upper extremity: long-term follow-up of 10 children

Authors

  • Mona I Winge Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  • Magne Røkkum Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo, Norway

DOI:

https://doi.org/10.2340/17453674.2022.4589

Abstract

Background and purpose: The evaluation of metaphyseal angular deformities in children includes indication and timing for corrective osteotomy, and possible need for several operations during growth. Gap-fillers are usually autologous bone grafts, which might cause donor site problems. Calcium phosphate (CaP) bone cement may be a possible alternative.
Patients and methods: We performed 15 corrective osteotomies from 2007 to 2013 in 10 children, ages 5 to 18, with Norian SRS bone cement as a gap-filler, in the distal radius (12), proximal radius (1), and proximal humerus (2). Due to growth arrest and gradually increasing malalignments 3/10 children needed 1–3 additional corrections. Locking plates and screws were used except in 1 case at first surgery, aged 5 (K-wires). 2 children needed additional limb lengthening with external fixator.
Results: All osteotomies healed. Postoperative radiographs and CT scans showed good alignment and gradual transformation of cement into bone. Remodeling was visible intraoperatively in patients needing multiple surgeries. Return to earlier osteotomy sites was unproblematic. No adverse events from using CaP cement were experienced.
Interpretation:  CaP cement is an alternative to bone grafts in upper extremity metaphyseal corrective osteotomies in children, and also when greater corrections are necessary or several surgeries indicated during the growth period.

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Published

2022-09-23

How to Cite

Winge, M. I., & Røkkum, M. (2022). Calcium phosphate bone cement and metaphyseal ­corrective osteotomies in the upper extremity: long-term follow-up of 10 children. Acta Orthopaedica, 93, 769–774. https://doi.org/10.2340/17453674.2022.4589

Issue

Section

Non-randomized clinical study