医学
骨形态发生蛋白
外科
松质骨
骨形态发生蛋白2
骨移植
内固定
植入
固定(群体遗传学)
非工会
骨不连
股骨骨折
骨愈合
髓内棒
牙科
股骨
化学
体外
基因
环境卫生
生物化学
人口
作者
Eric E. Johnson,Marshall R. Urist,Gerald A. M. Finerman
标识
DOI:10.1097/00003086-198805000-00031
摘要
Twelve patients with intractable nonunions of the femoral diaphyseal or metaphyscal-diaphyseal shaft were successfully treated by a combination of internal fixation and implants of human bone morphogenetic protein (h-BMP). There was an average of 4.3 surgical procedures per patient attempting union prior to h-BMP implantation. Union was obtained in 11 of 12 patients and in one patient with a repeat stabilization and implantation of h-BMP. Four patients received autogencic cancellous bone graft and four patients received allogeneic bone grafts. The BMP implant was prepared in the form of an aggregate of h-BMP and bone matrix water-insoluble noncollagenous proteins (h-BMP/iNCP). Fifty to 100 mg of h-BMP/iNCP was either implanted in the fracture gap in ultra thin gelatin capsules, or incorporated in a strip of polylactic/polyglycolic acid copolymer (PLA/PGA) and placed as an only across the fracture gap. The average time to union was 4.7 months. Further clinical investigations are planned as a series of matched cases with and without BMP augmentation in order to distinguish h-BMP effects from new or improved methods of fracture fixation combined with autogeneic cancellous bone grafts.
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