Research Article

The forgotten player in the surgical history

Yves Cirotteau*

Published: 05/13/2019 | Volume 2 - Issue 1 | Pages: 052-063


The research concerning a preventive treatment of an osteoporitic femoral neck fracture started in 1990 because the surgical procedure of unstable femoral neck fractures is difficult. After effects are frequent and their number will increase in the next decade. The goal is to reinforce the femur with a biomaterial acting as a bone graft.

Natural coral is bioresorbable and biocompatible. It acts as an autofocus bone graft for reconstruction of either cortex or cancellous bone and increases their mechanical resistance.

This work shows evidence of new bone formation in an osteoporotic unbroken femoral neck femur. Consequently, the preventive surgical treatment of osteoporosis should be taken in consideration [1]. The purpose of this work is to show the results on the mineralization of the cancellous bone of an upper femoral metaphyses when a natural biomaterial is set in an unbroken osteoporotic femoral neck.

Summary: Mrs. L is an 84 years old lady. Her osteoporotic unbroken right hip was grafted preventively with a biomaterial in order to prevent the high risk of break in case of fall. The biomaterial used is beads of natural coral. The reasons of this preventive treatment is discussed, as well as the choice of the biomaterial. The results are shown including a two years follow up.

Brief History: Before going further, few words of history. Three centuries BC, an Aristote’s follower, Théophraste thinks that Natural coral is a petrified plant.

Read Full Article HTML DOI: 10.29328/journal.ijbmr.1001005 Cite this Article


  1. The use of biocoral for hip fracture repair in ederly patients Biomineralization 93; 7th International Symposium on Bio mineralization; Monaco. 1993; 129-134.
  2. Cirotteau Y. Reconstruction des pertes de substances osseuses cotyloidiennes et fémorales lors des reprises de PTH à l’aide de corail naturel. Actualité en biomatériaux. 1993; 2: 179-187.
  3. Cirotteau Y. Upper femoral metaphysis morphological modifications of a human struck down by osteoporotic disease. Comptes Rendus de l'Académie des Sciences 1999; 401-411. Ref.:©
  4. Patat JL, Cantaloube D, Cirotteau Y. Natural coral as bone graft substitute biomaterial. Corallo di ieri, corallo di oggi. Cultural heritage sciences and materials. European University Center for Cultural Heritage. RAVELLO. 1996; 2000. Ref.:
  5. Cirotteau Y. Behavior of natural coral in a human osteoporotic bone. Eur J Orthop. 2001; 11: 149 -160. Ref.:
  6. Traum. Behavior of natural coral in a context of atrophic femoral non-union. Eur J Orthop.
  7. Treatment of bone diseases associated with demineralization of the bone. Official Health. Officiel Santé. SOFCOT 6/9. Nov 2006 ; 2 et 13 Ref.:
  8. Cornell CN. Management of fractures in patients with osteoporosis. Orthop Clinical North. 1990; 125-141. Ref.:
  9. Barrios C1, Broström LA, Stark A, Walheim G. Healing Complications after internal fixation of trochanteric hip fractures: The prognostic value of osteoporosis. J Orthop Trauma. 1993; 7: 438-442. Ref.:
  10. Laval-Jeantet AM, Bergot C. Quantitative imaging and absortiometry of bone in aging. Cahiers of Anthropology and Human Biometry. 13: 263-280.
  11. Patel A, Honnart F, Guillemin G, Patat JL. Use of skeletal madrepore fragments in orthopaedic and reconstructive surgery. Calcif Tis Int. 1980. 31(Suppl 108).
  12. Kehr PH, Graftiaux AG, Gosset F, Bencheikh K. Use of biocoral in cervical intersomatic grafting. Biomineralization 93, 7th international symposium on biominerial Monaco. 1993; 123-128.
  13. Ouhayoun JP, Isaahakian S, Patat JL, Shabana AHM, Guillemin G. Histological evaluationof natural coral skeleton as a rafting material in miniature swine mandible. J Materials Science. 1992; 3: 222-228 Ref.:
  14. Guillemin G. Madreporic materials in orthopedic surgery. Teaching Notes of the S.O.F.COT N ° 25 French Scientific Expansion (Ed) Paris. 1986; 91-100.
  15. Osteodensitometries are made by biphotonic absorptiometry with no danger of radiation by the use of microcosmes. Hologic QDR-1000/W (S/N 851). They are performed by C. Bergot MD. Service of radiology; Pr Laval-Jeantet MD, Head of Service, Saint-Louis Hospital, Paris.
  16. All soft issues are removed; The simples are embedded in a wet sheet and put under the machine (80 KV- 100 mA) in a frontal plane. 20 cuts, every 1,5 mm, are made from the anterior (1) to the posterior (20) side of both samples.
  17. Cirotteau Y. A physiological approach in stabilization and consolidation of unstable femoral neck fracture in osteoporotic patients - A retrospective review. 2003; 13: 145-155. Ref.:
  18. Cirotteau Y. Screw-plate angulation of 130° or 135° and 120° in the stabilization of an unstable trochanteric femoral neck fracture 2003; Eur J Orthop Surg Traumatol. 2003; 13: 173-178. Ref.:
  19. Cirotteau Y. Boyd HB, Griffin LL. Classification: A refinement proposal. Eur J Orthop Surg Traumatol. 2002; 12: 152-157. Ref.:
  20. Sacks O. The man who took his wife for a hat. Editions du Seuil. 1988; Ref.: