title: Bone morphogenic protein and its application in trauma cases: a current concept update.
abstract: BACKGROUND
  Bone morphogenic proteins (BMP) have shown tremendous potential in bone formation at fracture sites and at non-union sites. Animal studies and limited human studies have proven their efficacy as an alternative or enhancer of autologus bone graft in bone regeneration. The action of BMP is mediated through receptor kinases and transcription factors called Smads that regulate the expression of target genes. In preclinical studies, it was observed that BMP is relatively devoid of adverse effects and carcinogenicity but further studies are needed to clarify the issue of ectopic bone formation before its extensive use in humans.
  
  
  METHODS
  This review article intends to give brief information on biology and basic science of BMP and provide an overview on the current research data on clinical application of BMP in the treatment of fractures and difficult non-unions.
  
  
  RESULTS
  Various studies have shown that BMP holds promise in the management of delayed unions and recalcitrant non-unions. It has also been observed to initiate faster healing resulting in less pain and infection at the fracture site in open fractures. However the role of BMP in fresh fractures is debatable.
  
  
  CONCLUSIONS
  Judicious use of BMP in certain clinical scenarios may revolutionise management of non-unions and delayed unions. The major constraints for routine use of BMP are inadequate clinical trials in humans and the need to comprehensively assess the cost-effectiveness and budget impact of BMP.
authors.affiliation: CIIMS Hospital, Nagpur, India. vaibhavbagaria@rediffmail.com
authors.forename: Bagaria
authors.initials: B
authors.lastname: Vaibhav
authors.forename: Patil
authors.initials: P
authors.lastname: Nilesh
authors.forename: Sapre
authors.initials: S
authors.lastname: Vikram
authors.forename: Chadda
authors.initials: C
authors.lastname: Anshul
mesh_terms: D019485:Bone Morphogenetic Proteins / Q000502:physiology / Q000627:therapeutic use*; D017102:Fracture Healing / Q000187:drug effects; D005599:Fractures, Ununited / Q000188:drug therapy*; D006801:Humans
chemical_list: D019485:Bone Morphogenetic Proteins