The use of an injectable bone graft substitute in tibial metaphyseal fractures

Eight consecutive patients with severely comminuted proximal or distal tibial metaphyseal fractures were surgically treated with a novel injectable, in situ hardening calcium sulfate material to provide temporary intraoperative structural support until instrumentation was appropriately placed. The calcium sulfate bone substitute was also used as a bone void filler to provide an osteoconductive environment following stabilization. Bone regrowth was observed in all patients and, in seven of the eight patients, 90%-100% bone formation was observed within 3 months. The bone substitute had almost completely resorbed by 3 months in all patients. One patient with extensive initial bone loss required a second bone graft. Although the patient sample size was small, the success rate of treating severely comminuted fractures was significantly better than in reports using only internal fixation. Injectable bone substitute provides a viable alternative for minimally invasive surgery to repair metaphyseal fractures.