transforming-growth-factor-beta and Fractures--Comminuted

This article is another review of clinical application of the use of bone morphogenetic proteins, specifically rhBMP2 Infuse Bonegraft, in the treatment of both acute and chronic fracture and fusion situations. Overall experience is reported with particular detail to the use of biologics in the treatment of problems involving the tibia, foot, and ankle.

Topics: Adolescent; Adult; Aged; Ankle Injuries; Arthrodesis; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Female; Fibula; Fracture Healing; Fractures, Bone; Fractures, Comminuted; Humans; Male; Middle Aged; Prospective Studies; Recombinant Proteins; Reoperation; Tibial Fractures; Transforming Growth Factor beta; Young Adult

The off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of mandibular bone defects was evaluated in 5 patients. The rhBMP-2 was used as an alternative to autogenous bone grafting.. A total of 5 patients had mandibular defects reconstructed with rhBMP-2, 1.5 mg/mL, soaked collagen sponges alone or in combination with bone marrow cells and allogenic cancellous bone chips. Four of the patients had mandibular continuity defects and the fifth patient had 2 large bone cavities following removal of dentigerous cysts. Radiographs and clinical examinations were used to evaluate healing. The longest patient follow-up was 22 months after reconstruction.. Radiographic and clinical assessments revealed bone regeneration and restoration of the mandibular defects in 3 of the 5 patients. The rhBMP-2 failed in 2 patients with continuity defects. Both patients with failed rhBMP-2 grafts were successfully repaired using autogenous harvested from the iliac crest.. Mandibular bone defects can be successfully reconstructed using rhBMP-2 soaked sponges with and without including bone marrow cells and allogenic bone. Further studies are needed to determine the ideal combination of components that will predictably and reliably regenerate bone in different types of bone defects.

Topics: Adult; Aged, 80 and over; Bone Marrow Transplantation; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Bone Plates; Bone Regeneration; Bone Transplantation; Collagen; Female; Fractures, Comminuted; Humans; Jaw Cysts; Male; Mandible; Mandibular Diseases; Mandibular Fractures; Osteomyelitis; Recombinant Proteins; Tissue Engineering; Transforming Growth Factor beta

To report use of recombinant human bone morphogenetic protein-2 (rhBMP-2) as adjunctive therapy for treatment of a comminuted, open, proximal humeral fracture in an avian species.. Clinical report.. A 3.5-month-old male whooping crane (Grus americana).. An open, severely comminuted humeral facture was stabilized with an intramuscular (IM) pin/type IA external skeletal fixator with tie-in configuration. rhBMP-2 was applied in a calcium phosphate matrix (CPM) paste directly to the fracture site as a bone graft substitute. Radiographic evidence of bone healing was monitored for 14 weeks.. Substantial bony callus was evident at 4 weeks and at 8 weeks there was bridging callus with obvious bony remodeling. The fixation was destabilized at 9 weeks by IM pin removal, bone healing progressed and the fixator was removed at 11 weeks. By 14 weeks both cortices had been re-established with continued callus remodeling evident.. rhBMP-2, applied in a CPM paste, was used as a bone graft substitute in the treatment of a comminuted, open humeral fracture in a whooping crane.. Use of rhBMP-2/CPM should be considered in treatment of avian fractures.

Topics: Animals; Animals, Wild; Birds; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Bony Callus; Calcium Phosphates; Fracture Fixation, Internal; Fracture Healing; Fractures, Bone; Fractures, Comminuted; Humeral Fractures; Male; Recombinant Proteins; Transforming Growth Factor beta; Treatment Outcome

Reconstruction of a major bone loss remains a challenge for the orthopaedic surgeon. Most of the bone defects result from a bone tumour resection whereas a post-traumatic bone loss is more rare due to the numerous options available for bone fixation. However in high-energy trauma, the injury to bone may be so extensive as to justify removal of fragmented bone. A 57-year-old man presented with a severe injury at the thigh after a hunting accident, including a comminuted fracture of the femoral shaft. After thorough debridement, he was left with a large diaphyseal bone defect which was subsequently treated with a structural bone allograft, autogenous graft and rhBMP-7. Bone healing was achieved after several months.

Topics: Bone Morphogenetic Protein 7; Bone Morphogenetic Proteins; Bone Transplantation; Debridement; Femoral Fractures; Fractures, Comminuted; Humans; Male; Middle Aged; Transforming Growth Factor beta; Transplantation, Autologous; Transplantation, Homologous; Wounds, Gunshot