The use of nanocrystalline hydroxyapatite for the reconstruction of calcaneal fractures: Preliminary results.

The purpose of this investigation was to evaluate the feasibility of a nanocrystalline hydroxyapatite compound in the treatment of calcaneal fractures with osseous defects after reduction. The study included 21 patients, representing 24 closed intraarticular calcaneus fractures with large defects remaining after operative reduction. All cases were supplemented with the hydroxyapatite bone substitute and stabilized with a calcaneal honeycomb plate. Radiographs were taken at 6 weeks, 12 weeks, 6 months, and 1 year postoperatively, with specific attention given to measurement of Gissane's angle, Böhler's angle, and calcaneal height. A postoperative subjective and objective evaluation of the fracture, using the Creighton Nebraska Health Foundation scale, was performed 1 year postoperatively. Böhler's angle improved from a mean 8.6 +/- 5.3 degrees preoperatively to an immediate postoperative mean result of 31.5 +/- 6.5 degrees and 27.7 +/- 8.6 1 year postoperatively. The mean Creighton-Nebraska functional score was 86 +/- 10 at the 1-year follow-up evaluation. These results suggest that open reduction with plate fixation combined with nanocrystalline hydroxyapatite augmentation presents a good and reliable surgical technique for treatment of calcaneus fractures.