title: Treatment of recalcitrant atrophic non-union of the humeral shaft with BMP-7, autologous bone graft and hydroxyapatite pellets.
abstract: Recalcitrant humeral non-union is a disabling condition that is extremely difficult to treat. The use of BMP-7 has been proposed to improve bone healing. This is a report of the results obtained in 12 patients with recalcitrant humeral non-union treated using stable fixation with a long locking compression plate and BMP-7, autologous bone graft and hydroxyapatite pellets applied at the non-union site. Patients had up to three surgical attempts at non-union healing prior to our treatment. The average time from the initial fracture to our surgery was 5.2 years. Average follow-up was 5.3 years. At follow-up, non-union had healed in all patients by an average of 7.3 months. All the patients were very satisfied with their final results, despite a restricted range of motion of the elbow and a moderate muscular atrophy, which was frequently observed. Our study shows that BMP-7 associated with autologous bone grafting and hydroxyapatite pellets after stable fixation is an effective adjuvant to stimulate bone healing in the treatment of recalcitrant humeral non-union.
authors: Department of Orthopaedic Surgery, University of Rome "Tor Vergata", Viale Oxford 81, Rome, 00133, Italy.
authors: Roberto
authors: R
authors: Caterini
authors: Department of Orthopaedic Surgery, University of Rome "Tor Vergata", Viale Oxford 81, Rome, 00133, Italy.
authors: Vito
authors: V
authors: Potenza
authors: Department of Orthopaedic Surgery, University of Rome "Tor Vergata", Viale Oxford 81, Rome, 00133, Italy.
authors: Ernesto
authors: E
authors: Ippolito
authors: Department of Orthopaedic Surgery, University of Rome "Tor Vergata", Viale Oxford 81, Rome, 00133, Italy. Electronic address: farsetti@uniroma2.it.
authors: Pasquale
authors: P
authors: Farsetti
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D001672:Biocompatible Materials / Q000627:therapeutic use; D055419:Bone Morphogenetic Protein 7 / Q000627:therapeutic use; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D018483:Diaphyses / Q000473:pathology*; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: C525819:BMP7 protein, human; D001672:Biocompatible Materials; D055419:Bone Morphogenetic Protein 7; D017886:Durapatite
keywords: BMP-7; Humeral non-union; OP-1; bone morphogenetic protein; humeral shaft