ArticleJournal of orthopaedic case reports2024
Open Reduction and Internal Fixation with Bone Morphogenetic Protein-2 for Correction of Nonunion Humeral Shaft Fracture with Pseudoarthrosis in the Geriatric Population: A Case Report.
Article in Journal of orthopaedic case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Bone morphogenic protein-2 (BMP-2) is a potent growth factor cytokine, with indications for interbody spinal fusion surgery and open tibial shaft repairs due to its osteoinductive properties. Off-label usage of BMP-2 has been documented; however, there are limited studies regarding the efficacy of using BMP-2 in non-union humeral shaft fractures. Case Report: We present a case of a comminuted left humeral shaft fracture with pseudoarthrosis in a 64-year-old woman. Due to the patient's significant comorbidities, initial fracture management focused on non-surgical intervention with the use of a humeral cuff to correct the fracture. However, the patient's report of persistent and significant pain and serial radiographs indicating poor healing with a non-union fracture prompted surgical intervention. The patient underwent an open reduction and internal fixation (ORIF) with the application of one pledget of BMP-2 at the fracture site to promote osteogenesis. To the best of our knowledge, there is limited information about the efficacy of using BMP-2 for humeral fractures. Conclusion: Six months following the surgery, radiographs have shown appropriate fracture healing of the left humerus without loosening of hardware and other significant complications. The usage of BMP-2 in this patient has shown to be effective in promoting the healing of her nonunion humeral shaft fracture. Although BMP-2 has typically been FDA indicated for use in lumbar interbody spinal fusion surgery and open tibial shaft repairs, this case demonstrates that BMP-2 can also promote healing of non-union humeral shaft fractures in a safe and effective manner.
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