[Alloplastic cancellous bone replacement and fibrin glue in hand surgery].

Abstract

Introduction: Alloplastic replacement of cancellous bone is being increasingly used in the clinical setting. The use in hand surgery, however, is only sparsely documented.

Materials and methods: We report about the use of micro- and macroporous biphasic calicium phosphate granulate (Tricos (®)) in combination with fibrin sealant (Tissucol (®)) in six patients undergoing surgery of the hand involving cancellous bone deficits. The indications ranged from carpal stabilisation to DIP athrodesis. Follow-up time was up to 15 months.

Results: Because cancellous bone harvesting could be avoided, morbidity and the extent of surgery could be reduced in all patients. Healing was uneventful and the clinical course as documented by X-ray controls, toleration of physiotherapeutic exercises and stability was analogous to that of conventional surgery involving cancellous bone grafting.

Conclusion: These first results indicate that alloplastic replacement of spongiosa grafts, especially by micro- and macroporous biphasic calcium phosphate granulate can possibly be successfully used in surgery of the hand. The extent of bony remodelling still needs to be determined by further examination.