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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 134 - 134
1 Feb 2004
De Lucas-Cadenas P Beano-Aragòn A Almodòvar-Delgado JA Pérez-Fernández S Cobo-Soriano J
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Introduction and Objectives: Non-unions of long bones represents a challenge for the orthopaedic surgeon due to the difficulty of treatment and high use of resources (human, surgical, etc.) which certainly raises health care costs. The development of morphogenetic proteins for the treatment of this clinical condition provides a powerful means of achieving the desired result: consolidation of the non-union.

Materials and Methods: From June 2002 to May 2003, we treated 5 cases of non-union of long bones (2 of the humerus, 1 femur, 1 tibia, and one knee arthrodesis). The group included 3 males and one female, ranging in age from 23 to 71 years (mean 47.2 years). Three of the subjects had previously undergone surgery between 1 and 7 times. One case presented with a bone defect in the distal third of the humerus. All cases were treated using mechanical stabilisation of the fracture. In one case, a bone bank graft was used, and in another, an autologous graft was used.

Results: Bone healing was achieved in all cases, except in one humerus.

Discussion and Conclusions: BMP-7 (OP-1) appears to be an advance in the treatment of long bone non-unions. Though it does not eliminate the need for adequate surgical treatment of non-unions (resection of the focus, exposure until bleeding bone, and mechanical stabilisation), this method does favor osteogenesis at the fracture site and avoids the morbidity associated with extraction of autologous bone from the iliac crest.