title: Use of bone morphogenetic protein-2 (rh-BMP-2) in treatment of wrist and hand nonunion with comparison to historical control groups.
abstract: The purpose of this study is to report the percentage of patients achieving union, time to union, and complications with the use of bone morphogenetic protein-2 (rh-BMP-2) in surgical repair of established nonunion in the hand and wrist. Twenty-seven patients with nonunion of the hand and wrist were treated between 2005 and 2011 with surgical repair and augmentation using 4.2 mg of rh-BMP-2. Sites of nonunion included the phalanx (seven), carpus (nine), distal radius (five), and distal ulna (six). Radiographic union and complications were the primary and secondary outcomes, respectively. Eighty-nine percent (24/27) of patients achieved union within an average of 4.3 ± 2.8 months of surgery. There were no direct complications from administration of rh-BMP-2. Radiographic union was consistent with published rates for nonunion repair of scaphoid, phalanx, and distal radius fractures. Rh-BMP-2 did not produce superior rates of union in the patients with wrist and hand nonunion.
authors.affiliation: Department of Orthopedic Surgery, UPMC Hamot, Erie, Pennsylvania. riceians@gmail.com.
authors.forename: Ian
authors.initials: I
authors.lastname: Rice
authors.forename: John D
authors.initials: JD
authors.lastname: Lubahn
mesh_terms: D000293:Adolescent; D000328:Adult; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D005260:Female; D005599:Fractures, Ununited / Q000188:drug therapy* / Q000601:surgery; D006230:Hand Injuries / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins