Traumatic fracture treatment: Calcium phosphate bone substitute case-control study in humerus, radius, tibia fractures – assessing efficacy and recovery outcomes

Abstract text (incl. figure legends and references)

This study investigates the safety, resorption, healing process, and complications of synthetic bioactive bone substitute materials, specifically calcium phosphate-based bone substitutes (CP), in traumatically induced bone fractures. We hypothesize that CP could improve bone healing.

In this retrospective case-control study, over 290 patients who received surgical treatment for acute fractures were examined. CP augmentation was compared with empty defect treatment (ED) between 2011 and 2018. A new scoring system for fracture healing was used in up to six radiological follow-up examinations, and demographic data, concomitant diseases, and complications were analyzed.

Data analysis showed significantly fewer postoperative complications in the CP group compared to the ED group (p<0.001). Risks of pseudarthrosis (p<0.001), arthrosis (p=0.01), and neurological diseases (p<0.001) were decreased in the CP group. Intermediate follow-up examinations indicated enhanced fracture edge, gap, and articular surface (p<0.05). Osteosynthesis and general bone density were similar (p>0.05).

Subgroup analysis of patients aged over 64 years revealed fewer complications in the CP group (p=0.025). Geriatric patients benefited from CP materials with reduced pseudarthrosis (p=0.059) and improved fracture gap, edge, and articular surface in intermediate follow-ups (p<0.05).

In conclusion, calcium phosphate-based bone substitutes demonstrate safety in clinical applications, improved early osseous healing, and fewer severe complications. In vivo advantages were evident for CP bone graft substitutes.