Treatment of a Double Nonunion of the Femur by rhBMP-2
- 1 November 2007
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Orthopaedic Trauma
- Vol. 21 (10), 734-737
- https://doi.org/10.1097/bot.0b013e3181589700
Abstract
A 49-year-old patient sustained an ipsilateral fracture of the lateral femoral neck and distal femoral shaft, which were treated with a long intramedullary nail with a hip screw component. Both fractures did not heal, and both nonunion sites were revised by reosteosynthesis with a dynamic hip screw for the femoral neck and a locked intramedullary nail for the shaft region combined with autogenous bone grafting at both sites. At 14 months from injury and after 2 operations, both nonunions persisted. At a third surgery, 1 kit of recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge was applied to each site, without any modification of the osteosynthesis or additional bone grafting. The lateral femoral neck and the femoral shaft consolidated 24 and 30 weeks, respectively, after the rhBMP-2 application, and the patient resumed his work as industrial worker after 7 months after his last surgery. We believe this is the first study to report the successful use of 2 kits of rhBMP-2 in a double nonunion of the femur.Keywords
This publication has 19 references indexed in Scilit:
- Adverse swelling associated with use of rh-BMP-2 in anterior cervical discectomy and fusion: a case studyThe Spine Journal, 2007
- Increased Swelling Complications Associated With Off-Label Usage of rhBMP-2 in the Anterior Cervical SpineSpine, 2006
- Recombinant Human BMP-2 and Allograft Compared with Autogenous Bone Graft for Reconstruction of Diaphyseal Tibial Fractures with Cortical DefectsThe Journal of Bone & Joint Surgery, 2006
- Recombinant Human Bone Morphogenetic Protein-2 in Open Tibial FracturesThe Journal of Bone & Joint Surgery, 2006
- Global gene profiling reveals a downregulation of BMP gene expression in experimental atrophic nonunions compared to standard healing fracturesJournal of Orthopaedic Research, 2006
- Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixationInternational Orthopaedics, 2006
- Adverse Effects Associated With High-Dose Recombinant Human Bone Morphogenetic Protein-2 Use in Anterior Cervical Spine FusionSpine, 2006
- OSTEOGENIC ACTIVITY OF THE FOURTEEN TYPES OF HUMAN BONE MORPHOGENETIC PROTEINS (BMPS)The Journal of Bone and Joint Surgery-American Volume, 2003
- A Prospective, Randomized, Controlled Cervical Fusion Study Using Recombinant Human Bone Morphogenetic Protein-2 With the CORNERSTONE-SR™ Allograft Ring and the ATLANTIS™ Anterior Cervical PlateSpine, 2003
- Tibial Nonunion: Treatment AlternativesJournal of the American Academy of Orthopaedic Surgeons, 1996