Healing of a scaphoid nonunion using human bone morphogenetic protein.
A chronic nonunion of a proximal pole fracture of the scaphoid was treated by curettage of the nonunion, single K-wire fixation, and implantation of 50 mg of human bone morphogenetic protein followed by 12 weeks of cast immobilization without any conventional corticocancellous bone grafting or rigid screw fixation. Radiographs showed signs of bony healing by 12 weeks and a magnetic resonance imaging scan 6 years after surgery showed no signs of avascular necrosis. The potential future applications of human bone morphogenetic protein in hand surgery are discussed.
Jones
Neil F
NF
Department of Orthopedic Surgery and Division of Plastic and Reconstructive Surgery, University of California-Los Angeles, Los Angeles, CA 90095, USA. njones@mednet.ucla.edu
Brown
Erin E
EE
Mostofi
Amir
A
Vogelin
Esther
E
Urist
Marshall R
MR
D000293:Adolescent; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D001864:Bone Wires; D003475:Curettage; D004343:Drug Implants; D005538:Football / Q000293:injuries; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000628:therapy*; D006801:Humans; D008297:Male; D021361:Scaphoid Bone / Q000293:injuries*
D019485:Bone Morphogenetic Proteins; D004343:Drug Implants