Calcium Phosphate Cements in Fracture Repair

Calcium phosphate paste with endothermic hardening characteristic provides excellent support for well contained metaphyseal subarticular defects. There has been no evidence to date that any of the osteoconductive substances add anything to the healing of diaphyseal fractures or nonunions of long bones. However there is nice level one evidence available in the literature that promotes calcium phosphate cement as a viable alternate to autograft. The evidence to date would suggest that the use of calcium phosphate would improve the early maintenance of the subchondral reduction, improve pain and prevent late collapse. This is in addition to eliminating the requirement to make a second incision over the iliac crest and thus avoid all of the complications associated with this surgical endeavor.