Naslov
The use of BMPs in the treatment of congenital pseudarthosis of the tibia

Autori
Antičević, Darko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
SIROT Workshop s međunarodnim sudjelovanjem. Tema: "Temeljna znanzstvena istraživanja u ortopediji" / Roth, Sandor - Lovran, 2009, 3-3

Skup
SIROT Workshop s međunarodnim sudjelovanjem. Tema: "Temeljna znanzstvena istraživanja u ortopediji"

Mjesto i datum
Lovran, Hrvatska, 20.06.2009

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
congenital pseudarthrosis of tibia ; bone morphogenetic protein

Sažetak
Background Congenital pseudarthrosis of the tibia (CPT) is a rare and frustrating disease due to multiple unsuccessful surgeries and eventual amputation. Recently, few papers reported on the application of rhBMP-7 (osteogenic protein or OP-1 device) in children as adjuvant to standard treatment options. Patients and Methods In our Department eight children was treated for CPT in the last 25 years. There four boys and four girls. In four patient neurofibromatosis type I was present with equal gender distribution. According to Crawford classification there were one patient with type I, two patients with Type II and two patients with type III. For three patients classification was not possible due to previous surgeries in other institutions. One patient is on conservative regimen due to absence of pathologic fracture up to now. Seven patients were surgically treated at average age of 4 years. In the period before year 2000 different methods of treatment (external fixator, plate and screws, bone grafts, and amputation in one case) were applied. At average each of four patients has had 9 operations. After year 2000. four patients were treated according to EPOS recommendations, i. e. resection of pathologic bone, application of Ilizarov frame, transport of tibial segement with elongation of the leg. In two patients local application of BMP-7 (OP-1 device) was performed. Results In one patient use of BMP resulted in solid bone union despite 12 previous unsuccessful surgeries. In other patient on two occasions application of BMP resulted with failure. Two patients were treated without BMP. One had solid bone union with four and half year follow up. Second patients had two surgical procedures without BMP with final solid bone union and four year follow up. Discussion and conclusion Review of recent literature and personal experience with use of BMPs in children for treatment of CPT is showing that BMP could be used as adjuvant to standard surgical procedures in resistant cases before amputation is considered. It seems, BMPs are not beneficial as the first choice to enhance bone healing in CPT.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

POVEZANOST RADA