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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 of a 90-year-old woman (Case 8) with humeral fracture having a large displaced fragment. Bridging callus formation and bone union were found at 12 weeks. Remodeling of fracture sites progressed over time. β-TCP granules (arrows) were resorbed, but still visible even 10 monthsafter surgery.
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Figure 9: Radiographs of a 90-year-old woman (Case 8) with humeral fracture having a large displaced fragment. Bridging callus formation and bone union were found at 12 weeks. Remodeling of fracture sites progressed over time. β-TCP granules (arrows) were resorbed, but still visible even 10 monthsafter surgery.

Mentions: Similar radiological results were obtained in an 88-year old woman with subtrochanteric fracture. At 8 weeks, marked callus formation was found in the lateral cortical bone defect (Fig. 8). The patient died due to pneumonia at 10 weeks. In contrast, one case with humeral fracture showed slightly different results. Bridging callus formation and bone union were obtained at 12 weeks. Remodeling of fracture sites progressed over time, but β-TCP granules were still visible even 10 months after surgery (Fig. 9).


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 of a 90-year-old woman (Case 8) with humeral fracture having a large displaced fragment. Bridging callus formation and bone union were found at 12 weeks. Remodeling of fracture sites progressed over time. β-TCP granules (arrows) were resorbed, but still visible even 10 monthsafter surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 9: Radiographs of a 90-year-old woman (Case 8) with humeral fracture having a large displaced fragment. Bridging callus formation and bone union were found at 12 weeks. Remodeling of fracture sites progressed over time. β-TCP granules (arrows) were resorbed, but still visible even 10 monthsafter surgery.
Mentions: Similar radiological results were obtained in an 88-year old woman with subtrochanteric fracture. At 8 weeks, marked callus formation was found in the lateral cortical bone defect (Fig. 8). The patient died due to pneumonia at 10 weeks. In contrast, one case with humeral fracture showed slightly different results. Bridging callus formation and bone union were obtained at 12 weeks. Remodeling of fracture sites progressed over time, but β-TCP granules were still visible even 10 months after surgery (Fig. 9).

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