Pseudarthrosis in fibrous dysplasia treated with bone morphogenetic protein

Johannes Beckmann 1 , Franz Kock 1 , Markus Tingart 1 , Juergen Goetz 1 , Joachim Grifka 1 , and Jens Schaumburger 1
  • 1 Department of Orthopedic Surgery, University of Regensburg, 93077, Bad Abbach, Germany

Abstract

We present a case of pseudarthrosis in a patient suffering from polyostotic fibrous dysplasia of the right part of the body that was successfully treated with bone morphogenetic protein. Pseudarthrosis occurred after proximal femoral shaft fracture due to a motorcycle accident initially treated by intramedullary nailing. After revision, the patient was treated by pseudarthrosis debridement and grafting of bone morphogenetic protein-7/osteogenic protein-1, resulting in callus formation that allowed indolent full weight-bearing after 6 weeks. The underlying disease as well as the described treatment is discussed.

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  • [1] Pollandt K., Engels C., Werner M., Delling G., Fibrous dysplasia, Pathologe, 2002, 23, 351–356 http://dx.doi.org/10.1007/s00292-002-0553-1

  • [2] Campanacci M., Bone and soft tissue tumors: Clinical features, imaging, pathology, and treatment, 2nd Ed., Berlin Heidelberg New York, Springer, 1999.

  • [3] DiCaprio M.R., Enneking W.F., Fibrous dysplasia. Pathophysiology, evaluation, and treatment, J. Bone Joint Surg. Am., 2005, 87, 1848–1864 http://dx.doi.org/10.2106/JBJS.D.02942

  • [4] Leet A.I., Chebli C., Kushner H., Chen C.C., Kelly M.H., Brillante B.A., et al., Fracture incidence in polyostotic fibrous dysplasia and the McCune-Albright syndrome, J. Bone Miner. Res., 2004, 19, 571–577 http://dx.doi.org/10.1359/JBMR.0301262

  • [5] Rodl R., Gotze C., Fibrous dysplasia, Orthopade, 2008, 37, 49–55 http://dx.doi.org/10.1007/s00132-007-1180-6

  • [6] Friedlaender G.E., Perry C.R., Cole J.D., Cook S.D., Cierny G., Muschler G.F., et al., Osteogenic protein-1 (bone morphogenetic protein-7) in the treatment of tibial nonunions, J. Bone Joint Surg. Am., 2001, 83-A, Suppl 1,(Pt 2), S151–S158

  • [7] Mont M.A., Ragland P.S., Biggins B., Friedlaender G., Patel T., Cook S., et al., Use of bone morphogenetic proteins for musculoskeletal applications. An overview, J. Bone Joint Surg. Am., 2004, 86-A, Suppl 2, 41–55

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