Treatment of a Segmental Defect in Open Radial and Ulnar Shaft Fractures Using rhBMP-2 and Iliac Crest Bone Graft: A Case Report

摘要

Introduction Segmental defects and delayed healing of long bone fracture remains a major problem among orthopedic surgeons. Nonunion of the forearm as a result of complex open fracture can result in imbalance in the main anatomical structures, leading to impaired function [17]. Therefore, the treatment of these defects must include the restoration of length and alignment in order to restore functional forearm motion [21]. Current treatment options for segmental long bone defects includes autogenous bone grafting, bone shortening, plate fixation combined with either intercalary non-vascularized structural (corticocancellous) bone grafts, vascularized grafts, or amputation [9]. The identification of recombinant human bone morphogenetic protein-2 (rhBMP-2) has led to revolu- tionary treatment options in certain orthopedic procedures. Currently, rhBMP-2 is approved by the United States Food and Drug Administration (FDA) for spine fusion [7, 11, 13, 16], tibial fractures [12, 14], and oral maxillofacial [4–6] procedures.