USE OF -β-TRICALCIUM PHOSPHATE ® (CHRONOS , SYNTHES) IN COMMINUTED VS NON-COMMINUTED LONG BONE FRACTURES FOR FRACTURE HEALING

Abstract

Background: Bone graft substitutes are a group of substances available to us today, which are now being increasingly used to enhance/ stimulate bone healing. The reason for this is because they obviate the need for an additional procedure, decrease operative time and are not associated with any donor site morbidity. We endeavored to find out if β-tricalcium phosphate (ChronOS®, Synthes) as a substitute gave better union rates in comminuted long bone fractures as against using them in simple fractures which had gone into nonunion, or delayed union, and to compare the complications that occurred.

Methods. This study was a retrospective review of prospectively collected data of patients that underwent bone stimulating procedures using ChronOS® (β-tricalcium phosphate) in cases such as nonunion, delayed union or acute comminuted fractures. There were 38 patients, who underwent bone enhancing procedures within a 1-year period, of which in 18 patients ChronOS® was used. Of the 18 patients, 10 were comminuted fractures and 8 were simple fractures the outcomes assessed were union time, comparison of union for each indication and occurrence of any complications or the need for secondary procedures.

Results: The results showed that at 3 months signs of union were evident in both groups. 80% (8 out of 10) of the comminuted fractures and 87.5% (7 out of 8) of the simple fractures went on to unite. 2 patients in the comminuted fracture group and one patient in the simple (non-comminuted fracture) group went on to non-union.

Conclusion: ChronOS® is a viable alternative to autograft in comminuted fractures as well as non-unions, delayed unions and the management of small bone defects. It completely eliminates donor site morbidity associated with autografts in addition to decreasing the operative time.