Clinical and radiological results of calcium phosphate cement-assisted balloon osteoplasty for Colles' fractures in osteoporotic senile female patients.

Abstract

Distal radius fractures in osteoporotic senile female patients often used to be complicated with residual deformity, stiffness, and pain. Recently, however, adequate usage of a palmar locking plate or external fixation has led to fewer subsequent complications. The method proposed here deserves consideration because it is less invasive and more cost-effective. A total of 11 Colles' type fractures (AO type A2) in 11 patients (all female; mean age 78 years) were treated. After a closed reduction, the fractures were fixed by percutaneous pinning, as Kapandji previously described. Through a 5-mm longitudinal skin incision on the dorsoulnar aspect of the fracture site, the barrel of a disposable 1-ml syringe was inserted into the fracture site as a port. Next, a pediatric uromatic balloon was introduced into the fracture site and inflated by contrast medium. The balloon inflation enlarged the void of the fracture site. A compression bandage around the fracture site was applied before calcium phosphate cement injection with a cement gun through the port under an image intensifier. The functional and radiological results were evaluated. The mean follow-up period was 16 months (range 12-25 months). All results were graded as good or excellent within 3 months, and all were graded as excellent at the final follow-up. The average duration of immobilization was 4 weeks with a short forearm cast. The overall postoperative correction loss in ulnar variance was 1.7 mm. Radial inclination and volar tilt showed no postoperative correction loss. The final volar tilt, radial inclination, and ulnar variance were comparable to those of the nonaffected side. Calcium phosphate cement-assisted balloon osteoplasty is a less invasive procedure and can be clinically justified as a therapeutic option for a Colles' fracture in osteoporotic senile female patients.