The Effect of Platelet-Rich Fibrin Supplemented with Calcium Phosphate-Based Powder on the Treatment of Metacarpal and Metatarsal Fractures in Cats: A Retrospective Study

Öz

The inorganic matrix of bone consists predominantly of calcium phosphate compounds. Among these, calcium phosphate ceramics are widely employed as bioactive materials due to their close structural resemblance to native bone tissue. Platelets, conversely, are rich in cytokines and growth factors that play critical roles in promoting osteogenesis and soft tissue repair. This biological synergy has led to the hypothesis that a combination of calcium phosphate-based biomaterials and platelet-rich fibrin (PRF) may enhance bone regeneration outcomes. Metacarpal and metatarsal fractures are frequently encountered in feline patients, accounting for approximately 3.3% of all reported fractures. Surgical intervention is typically indicated in cases involving displacement, multiple (>2) metacarpal/metatarsal fractures, or comminuted fracture patterns. This study evaluated 10 feline patients of varying breeds, sexes, and ages diagnosed with metacarpal or metatarsal fractures through comprehensive clinical and radiographic assessment. Of these, five cases (Cases 1, 4, 6, 7, and 8) presented with metacarpal fractures, while the remaining five (Cases 2, 3, 5, 9, and 10) exhibited metatarsal fractures. The therapeutic approach consisted of intramedullary fixation using Kirschner wires (K-wires), supplemented with the local application of a composite biomaterial composed of PRF and calcium phosphate-based powder directly at the fracture site. Postoperative follow-up was conducted through day 45. By this time point, all cases demonstrated weight-bearing capability on the affected limb, radiographic resolution of the fracture line, and satisfactory functional recovery. The objective of this study was to evaluate the efficacy of platelet-rich fibrin enriched with calcium phosphate-based powder in the surgical management of feline metacarpal and metatarsal fractures and to disseminate these findings for clinical application in veterinary practice.

Anahtar Kelimeler

• Calcium phosphate
• cat
• fracture
• metacarpus
• metatarsus
• platelet-rich fibrin

Kalsiyum Fosfat Esaslı Toz Eklenmiş Plateletten Zengin Fibrinin Kedilerin Metacarpus ve Metatarsus Kırıklarının Sağaltımına Etkisi: Retrospektif Çalışma

Öz

Kemiğin inorganik kısmının nerdeyse tamamı kalsiyum fosfat esaslıdır. Kalsiyum fosfat seramikleri, oldukça sık kullanılan biyoaktif seramiklerdendir ve kemik dokunun yapısına çok yakın bir yapıdadır. Trombositler ise kemik rejenerasyonunu ve yumuşak doku matürasyonunu sağlayan çok sayıda sitokin ve büyüme faktörü içerirler. Bu durum kalsiyum fosfat esaslı materyallerle plateletten zengin fibrin kombinasyonunun kemik yapımında veya rejenerasyonunda kullanılması fikrini akla getirmiştir. Metakarpal ve metatarsal kırıklar kedilerde sık görülmektedir. Çeşitli sebeplerle meydana gelen bu kırıklar kedilerde meydana gelen bütün kırıkların %3,3’ünü oluşturmaktadır. Deplasman görülen olgularda, ikiden fazla metakarpus/metatarsus kırığı olan olgularda veya parçalı kırıklarda cerrahi sağaltım önerilmektedir. Çalışma materyalini farklı ırk, cinsiyet ve yaşta, klinik ve radyolojik muayeneleri sonucunda metakarpus veya metakarpus kırığı tespit edilmiş olan 10 kedi oluşturmuştur. Çalışmaya dâhil edilen 10 kedinin 5’inde metakarpus (Olgu no 1, 4, 6, 7 ve 8), geri kalan 5’inde de (Olgu no 2, 3, 5, 9 ve 10) metatarsus kırığı teşhisi konmuştur. Sağaltımda intramedullar kirschner teli uygulamasına ek olarak kalsiyum fosfat esaslı toz eklenmiş plateletten zengin fibrin kombinasyonu kırık hattına uygulanmış ve olgular postoperatif 45. güne kadar takip edilmiştir. Postoperatif 45. güne gelindiğinde olguların tamamında ekstremiteye ağırlık verebildikleri, kırık hattının ortadan kalktığı ve fonksiyonel iyileşmenin sağlandığı görülmüştür. Bu çalışmada kalsiyum fosfat esaslı toz eklenmiş plateletten zengin fibrinin kedilerin metacarpus ve metatarsus kırıklarının sağaltımına etkisinin araştırılması ve sonuçlarının klinisyen veteriner hekimlerle paylaşılması amaçlanmıştır.

Anahtar Kelimeler

• Kalsiyum fosfat
• kedi
• kırık
• metakarpus
• metatarsus
• plateletten zengin fibrin

Kaynakça

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