Injectable calcium phosphate bone cement Norian SRS for the treatment of intra-articular compression fractures of the distal radius in osteoporotic women

Background: Distal radius fracture often presents a metaphyseal void which is more extended in elderly, osteoporotic patients. Bone graft and bone substitutes are reported to be beneficial in maintaining metaphyseal reduction. Methods: We performed a prospective study on 52 menopausal, osteoporotic women with unstable intra-articular distal radius fractures to compare the outcome of percutaneous pinning and immobilisation in a cast for 6 weeks with that using injectable calcium phosphate bone cement (Norian Skeletal Repair System, SRS) to supplement pin and screw fixation and immobilisation in a cast for 3 weeks. All patients were reviewed 2 years (range 21-29 months) after surgery, Results: Patients treated with SRS had better functional outcome, restoration of movement and grip strength (p<0.001). In this group there was 1 min loss of radial length, 3degrees loss of radial inclination and 7degrees loss of palmar tilt. In the control group radial length decreased 3 mm, radial inclination decreased 11degrees and palmar tilt 12degrees. Loss of reduction was significantly higher in the control group (p<0.001). Conclusion: We conclude that the use of Norian SRS to supplement pin and screw fixation is effective in maintaining the reduction of unstable intra-articular distal radius fractures in osteoporotic patients and provides a better clinical outcome than percutaneous pinning.