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An Injectable Complex of β-tricalcium Phosphate Granules, Hyaluronate, and rhFGF-2 on Repair of Long-bone Fractures with Large Fragments.

Tanaka T, Kumagae Y, Chazono M, Komaki H, Kitasato S, Kakuta A, Marumo K - Open Biomed Eng J (2014)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: NHO Utsunomiya National Hospital, Department of Orthopaedic Surgery, 2160 Shimo-Okamoto, Utsunomiya City, Tochigi, 329-1193, Japan.

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.

No MeSH data available.


Related in: MedlinePlus

Radiographs and a CT image of four unstable intertrochantericfracture cases (A;Case 2, B;Case 3, C;Case 4, and D;Case 5). Initialradiographs (A1, B1, C1, and D1).Immediate postoperative radiographs (A2, B2, C2,and D2). Follow-up radiographs at 8 weeks (A3, B3, C3, and D3) and at 12 weeks (A4,B4, C4,and D4). Broken ovals indicate the remaining complex ofβ-TCP granules,hyaluronate, and FGF-2 and arrow heads indicate callus.
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Figure 5: Radiographs and a CT image of four unstable intertrochantericfracture cases (A;Case 2, B;Case 3, C;Case 4, and D;Case 5). Initialradiographs (A1, B1, C1, and D1).Immediate postoperative radiographs (A2, B2, C2,and D2). Follow-up radiographs at 8 weeks (A3, B3, C3, and D3) and at 12 weeks (A4,B4, C4,and D4). Broken ovals indicate the remaining complex ofβ-TCP granules,hyaluronate, and FGF-2 and arrow heads indicate callus.

Mentions: No major adverse effect such as infection was found in any patient. Two weeks after surgery, β-TCP granules were clearly visible in their original place, but new bone formation was not observed. Four weeks after surgery the margins of the β-TCP granules were unclear and new bone formation was found in 11 cases. By 8 weeks after surgery, most of the β-TCP granules had disappeared and callus formation was seen in all cases (Figs. 3 and 5). At 12 weeks, union of the intertrochanteric fracture and marked new bone formation were found around the lesser trochanter in all cases (Figs. 3, 5, and 6). No varus deformity more than 5° was observed.


An Injectable Complex of β-tricalcium Phosphate Granules, Hyaluronate, and rhFGF-2 on Repair of Long-bone Fractures with Large Fragments.

Tanaka T, Kumagae Y, Chazono M, Komaki H, Kitasato S, Kakuta A, Marumo K - Open Biomed Eng J (2014)

Radiographs and a CT image of four unstable intertrochantericfracture cases (A;Case 2, B;Case 3, C;Case 4, and D;Case 5). Initialradiographs (A1, B1, C1, and D1).Immediate postoperative radiographs (A2, B2, C2,and D2). Follow-up radiographs at 8 weeks (A3, B3, C3, and D3) and at 12 weeks (A4,B4, C4,and D4). Broken ovals indicate the remaining complex ofβ-TCP granules,hyaluronate, and FGF-2 and arrow heads indicate callus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4157360&req=5

Figure 5: Radiographs and a CT image of four unstable intertrochantericfracture cases (A;Case 2, B;Case 3, C;Case 4, and D;Case 5). Initialradiographs (A1, B1, C1, and D1).Immediate postoperative radiographs (A2, B2, C2,and D2). Follow-up radiographs at 8 weeks (A3, B3, C3, and D3) and at 12 weeks (A4,B4, C4,and D4). Broken ovals indicate the remaining complex ofβ-TCP granules,hyaluronate, and FGF-2 and arrow heads indicate callus.
Mentions: No major adverse effect such as infection was found in any patient. Two weeks after surgery, β-TCP granules were clearly visible in their original place, but new bone formation was not observed. Four weeks after surgery the margins of the β-TCP granules were unclear and new bone formation was found in 11 cases. By 8 weeks after surgery, most of the β-TCP granules had disappeared and callus formation was seen in all cases (Figs. 3 and 5). At 12 weeks, union of the intertrochanteric fracture and marked new bone formation were found around the lesser trochanter in all cases (Figs. 3, 5, and 6). No varus deformity more than 5° was observed.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: NHO Utsunomiya National Hospital, Department of Orthopaedic Surgery, 2160 Shimo-Okamoto, Utsunomiya City, Tochigi, 329-1193, Japan.

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.

No MeSH data available.


Related in: MedlinePlus