Calcium phosphate based Synthetic Bone Construct (SBC) as a temporary spacer for bone defect before bone transport
INTRODUCTION: Bone defect following resection of unhealthy bone often become contracted and fill with fibrous tissue. This will lead to resistance during bone transport, fibrous tissue interposition and skin invagination at the docking site. We report a case where synthetic bone constructs (SB...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association (MOA)
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/63989/ http://irep.iium.edu.my/63989/ http://irep.iium.edu.my/63989/1/Calcium%20Phosphate%20Based%20Synthetic%20Bone%20Construct%20%28SBC%29%20As%20A%20Temporary%20Spacer%20For%20Bone%20Defect%20Before%20Bone%20Transport.pdf |
| Summary: | INTRODUCTION:
Bone defect following resection of unhealthy
bone often become contracted and fill with
fibrous tissue. This will lead to resistance during
bone transport, fibrous tissue interposition and
skin invagination at the docking site. We report a
case where synthetic bone constructs (SBC) was
used as a temporary spacer to prevent valley
formation and soft tissue interposition during
bone transport. The SBC dissolved slowly and
thus allowing the bone to be transported with
minimal resistance and preventing fibrous tissue
formation in the bone gap.
METHODS:
A 30 year-old lady had a 4 cm bone gap
following resection of unhealthy bone for nonunion
following open grade IIIB distal tibia
fracture. The gap was filled with SBC and
ilizarov circular frame was assembled for bone
transport. SBC is a biodegradable
osteoconductive material made from calcium
phosphate based materials. It is manufactured by
Granulab (M) Sdn Bhd in a GMP accredited
factory and certified by British Standard Institute
(BSI). 5 cc of SBC was mix with 4 mls of bone
marrow aspirate in a cup. It is mix in a sterile OT
environment and put in a mold to make it into
small pellet. The mixture was allowed to be
hardened for 20 minutes before inserted into the
bone defect.
RESULTS:
The transported segment docks after 2 month.
There was no skin invagination and valley
formation. When the docking site was opened,
the gap was filled with partially dissolved
calcium phosphate. There was minimal soft
tissue interposition.
Figure 1: Plain radiograph post op, 1 month and
during docking
Figure 2: Clinical picture during mixing of SBC
with marrow aspirate, making pellet using mold
and opening of docking site showing calcium
phosphate material with minimal fibrous tissue
interposition.
DISCUSSIONS:
Although calcium phosphate has
osteoconductive property, we did not observe
any any bone formation at the gap although we
mix it with bone marrow aspirate. Calcium
Phosphate can also be used as an antibiotic
carrier for local slow release delivery following
resection of infected bone.
CONCLUSION:
Calcium phosphate is effective as a temporary
spacer to fill the gap during bone transport.
REFERENCES:
1. Thirumal M. Med J Malaysia.2001; 56:44-52
2. McKee M et al. J Orthop Trauma 201;.24:
483-490 |
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