title: Demineralized Bone Matrix Add-On for Acceleration of Bone Healing in Atypical Subtrochanteric Femoral Fracture: A Consecutive Case-Control Study.
abstract: BACKGROUND
  Delayed union and nonunion are common complications in atypical femoral fractures (AFFs) despite having good fracture fixation. Demineralized bone matrix (DBM) is a successfully proven method for enhancing fracture healing of the long bone fracture and nonunion and should be used in AFFs. This study aimed to compare the outcome after subtrochanteric AFFs (ST-AFFs) fixation with and without DBM.
  
  
  METHODS
  A prospective study was conducted on 9 ST-AFFs patients using DBM (DBM group) during 2013-2014 and compared with a retrospective consecutive case series of ST-AFFs patients treated without DBM (2010-2012) (NDBM group, 9 patients). All patients were treated with the same standard guideline and followed up until fractures completely united. Postoperative outcomes were then compared.
  
  
  RESULTS
  DBM group showed a significant shorter healing time than NDBM group (28.1 ± 14.4 versus 57.9 ± 36.8 weeks, p = 0.04). Delayed union was found in 4 patients (44%) in DBM group compared with 7 patients (78%) in NDBM group (p > 0.05). No statistical difference of nonunion was demonstrated between both groups (DBM = 1 and NDBM = 2, p > 0.05). Neither postoperative infection nor severe local tissue reaction was found.
  
  
  CONCLUSIONS
  DBM is safe and effective for accelerating the fracture healing in ST-AFFx and possibly reduces nonunion after fracture fixation. Trial registration number is TCTR20151021001.
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Noratep
authors.initials: N
authors.lastname: Kulachote
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Paphon
authors.identifier: 0000-0003-1936-4456
authors.initials: P
authors.lastname: Sa-ngasoongsong
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Norachart
authors.initials: N
authors.lastname: Sirisreetreerux
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pongsthorn
authors.initials: P
authors.lastname: Chanplakorn
authors.affiliation: Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Praman
authors.initials: P
authors.lastname: Fuangfa
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chanyut
authors.initials: C
authors.lastname: Suphachatwong
authors.affiliation: Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wiwat
authors.initials: W
authors.lastname: Wajanavisit
mesh_terms: D000368:Aged; D001857:Bone Matrix; D018786:Bone Substitutes / Q000008:administration & dosage*; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D018786:Bone Substitutes