title: An Injectable Complex of β-tricalcium Phosphate Granules, Hyaluronate, and rhFGF-2 on Repair of Long-bone Fractures with Large Fragments.
abstract: We evaluated the effects of an injectable complex of β-tricalcium phosphate (β-TCP) granules, hyaluronate, and recombinant human fibroblast growth factor-2 (rhFGF-2) on repair of unstable intertrochanteric fractures in elderly patients. Twenty-five patients (range, 76-91 years) having 31.A2 fractures (AO classification) were treated with injection of the complex followed by intramedullary nails. Bone regeneration and β-TCP resorption, unions of intertrochanteric fractures and displaced lesser trochanters to the shaft, and varus deformity of the femoral neck were assessed by X-ray and CT scans. Fracture union occurred in all cases and union of the displaced lesser trochanter to the shaft was obtained in 24 cases by 12 weeks. It is of interest that β-TCP granules were completely resorbed and marked new bone formation around the lesser trochanter was observed in all cases compared to cases not treated with the complex. Based on the results of intertrochanteric fractures, we applied this technique to two patients with subtrochanteric or humeral fractures in elderly patients, and obtained bone union. This complex is a paste-like material that is easy to handle, and it may be of considerable use in treatment of both unstable intertrochanteric fractures and other cortical bone defects with minimal surgical invasion.
authors.affiliation: NHO Utsunomiya National Hospital, Department of Orthopaedic Surgery, 2160 Shimo-Okamoto, Utsunomiya City, Tochigi, 329-1193, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: NHO Utsunomiya National Hospital, Department of Orthopaedic Surgery, 2160 Shimo-Okamoto, Utsunomiya City, Tochigi, 329-1193, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kumagae
authors.affiliation: NHO Utsunomiya National Hospital, Department of Orthopaedic Surgery, 2160 Shimo-Okamoto, Utsunomiya City, Tochigi, 329-1193, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Chazono
authors.affiliation: Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Komaki
authors.affiliation: Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kitasato
authors.affiliation: Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kakuta
authors.affiliation: Jikei University School of Medicine, Tokyo 105-8461, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Marumo
keywords: An injectable complex beta-TCP; FGF-2; bone defects; fractures,.