| Summary: | Specific aims
The aim is to improve the treatment of the bone losses at the metacarpal bones level (both
diaphysis and epiphysis) combining microsurgery, tissue engineering and biomaterials, so to
minimize the donor side morbidity and optimize healing and outcomes.
Methods
Pre-operative controlateral X-ray or 3-D CT to allow custom-made HA scaffolds. Cement as
temporary spacer in acute lesion and monitoring of infective risks. Treatment of the bone loss
recurring to pre-fabricated or custom-made HA scaffolds, adding platelet gel or growth factor
OP1. Stable synthesis. Control group with auto/omografts. Outcome indices: % of bone-union;
finger TAM, Kapandji, DASH score; NMR and Scintigraphy at 180 days for revascularisation
and bio-substitution of the scaffold.
Preliminary results
The authors just treated 6 patients, 4 males and 2 females, with an average age of 38.5 yrs,
affected by segmental bone losses at the hand and wrist, recurring to pre-fabricated not
vascularised scaffolds. In all cases the synthesis was performed with angular stability plates and
a stable synthesis achieved. All patients have been controlled at a mean follow-up of 10.5
months (from 2 to 16 ). In all case but one the bone-scaffold osteo-integration was achieved at an
average of 38 days at the hand, and 46 days at the wrist. The outcome studies, according to the
DASH score, finger TAM, and Kapandji, were good and excellent in 5 cases, poor in one.
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