ABSTRACT
Between 2003 to 2006, twenty eight selected distal radial fractures in 27 patients operated in the division of emergency surgery, department of orthopedics and traumatology, Al Azhar university and other specialized centers were followed clinically and radiologically. Injectable bioactive calcium phosphate cement was used in conjunction with osteosynthesis or external fixation to correct metaphyseal bone defects experienced after reduction due to comminution. Fracture fixation/fragment stabilization was individualized according to every case. Percutaneous pins were used in 10 [35.7%] fractures, small fragment plate and screws in 3[10.7%] supplemental removable external splint immobilization for 4-6 weeks was used when indicated. External fixator helped with K-wires if necessary was used in 12[42.9%] fractures and Plaster-of-Paris splint or cast support in the remaining 3[10.7%]. Of the 27 patients, 23 [85.2%] were males and 4[14.8%] were females. Mean age at surgery was 33 years [range 21 to 59 years]. There were 17 [63%] right, 9[33.3%] left and 1 [3.7%] bilateral cases. Fractures were classified into three AO groups, accordingly, cases were graded; A [21.4%], B[17.9%] and C[60.6%]. Standard X-rays were used for radiological evaluation in all patients. Wrist scoring system developed by Cooney, et al., was employed for clinical assessment [9]. At a mean follow up 9.6 months [range 11-29 months], the overall results were: 17[60.7%] excellent,6 [21.4%] good, 2 [7.1%] fair and 3[10.7%] poor. In conclusion, calcium phosphate cement represent a good spacer biologically and biomcchanically, resulted in improved treatment outcomes for patients with comminuted fractures of the distal radius