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Báo cáo y học: ": Revision of a nonunited subtrochanteric femoral fracture around a failed intramedullary nail with the use of RIA products, BM"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Revision of a nonunited subtrochanteric femoral fracture around a failed intramedullary nail with the use of RIA products, BMP-7 and hydroxyapatite: a case report Tzioupis et al | JOURNALOF MEDICAL Lr CASE reports Revision of a nonunited subtrochanteric femoral fracture around a failed intramedullary nail with the use of RIA products BMP-7 and hydroxyapatite a case report Tzioupis et al. BioMed Central Tzioupis et al. Journal of Medical Case Reports 2011 5 87 http wwwjmedicalcasereports.com content 5 1 87 1 March 2011 Tzioupis et al. Journal of Medical Case Reports 2011 5 87 http www.jmedicalcasereports.eom content 5 1 87 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Revision of a nonunited subtrochanteric femoral fracture around a failed intramedullary nail with the use of RIA products BMP-7 and hydroxyapatite a case report 1 1 J I z 1 1.2 Christopher Tzioupis Pavlos Panteliadis Zakareya Gamie Eleftherios Tsiridis Abstract Introduction Femoral subtrochanteric fractures are commonly treated using intramedullary devices. Failure of the implant and subsequent nonunion is still an issue however and limited evidence exists regarding the most appropriate treatment. Case presentation We report the case of an 80-year-old Caucasian woman with a subtrochanteric fracture originally treated using a trochanteric gamma nail which failed resulting in a nonunion and fracture of its proximal end. The nonunion was revised with the removal of the broken trochanteric gamma nail application of a condylar blade plate ipsilateral Reamer Irrigator Aspirator autografting recombinant human bone morphogenetic protein-7 and injectable hydroxyapatite cement. The fracture united fully at ten months following revision surgery with no signs of femoral head avascular necrosis at 18-month follow-up. Conclusion The essential requirements for success when revising a nonunited fracture are to provide anatomical reduction mechanical stability bone defect augmentation and biological stimulation to achieve healing. Current advances in molecular biology such as recombinant human bone morphogenetic protein-7 and biotechnology such as the Reamer Irrigator Aspirator system