scholarly journals Bone healing of distal radius nonunion treated with bridge plating with bone graft substitutes in combination with systemic romosozumab administration: A case report

2021 ◽  
Vol 32 (2) ◽  
pp. 526-530
Author(s):  
Takuya Uemura ◽  
Koichi Yano ◽  
Kiyohito Takamatsu ◽  
Yusuke Miyashima ◽  
Hiroyuki Yasuda ◽  
...  

Romosozumab is a humanized, anti-sclerostin monoclonal antibody used to treat osteoporosis, which increases bone formation and decreases bone resorption. It enhances fracture healing and systemic romosozumab administration may have therapeutic potentials for accelerating bone healing of even nonunion. Herein, a 61-year-old heavy smoker male with distal radius nonunion who achieved successful bone union by combination therapy of romosozumab and spanning distraction plate fixation with bone graft substitutes was presented. Through the dorsal approach, atrophic comminuted nonunion of the distal radius was sufficiently debrided. Reduction of the distal radius was performed using indirect ligamentotaxis, and a 14-hole locking plate was fixed from the third metacarpal to the radial shaft. A beta (β) tricalcium phosphate block was mainly packed into the substantial metaphyseal bone defect with additional bone graft from the resected ulnar head. Postoperatively, systemic administration of monthly romosozumab was continued for six months. Complete bone union was achieved 20 weeks postoperatively and the plate was, then, removed. Wrist extension and flexion improved to 75o and 55o, respectively, without pain, and grip strength increased 52 weeks postoperatively from 5.5 kg to 22.4 kg. During romosozumab treatment, bone formation marker levels increased rapidly and finally returned to baseline, and bone resorption marker levels remained low. In conclusion, combination of systemic romosozumab administration and grafting β-tricalcium phosphate with bridge plating provides an effective treatment option for difficult cases of comminuted distal radius nonunion with risk factors such as smoking, diabetes, and fragility.

2021 ◽  
pp. 161-170
Author(s):  
Pascal F.W. Hannemann ◽  
Taco J. Blokhuis ◽  
Jan A. Ten Bosch ◽  
Niels W.L. Schep

2010 ◽  
Vol 654-656 ◽  
pp. 2065-2070
Author(s):  
Ho Yeon Song ◽  
Young Hee Kim ◽  
Jyoti M. Anirban ◽  
In Seon Byun ◽  
Kyung A Kwak ◽  
...  

Calcium phosphate ceramics such as hydroxy apatite (HA), β-tricalcium phosphate (β-TCP) and bicalcium phosphate (BCP) have been used as a bone graft biomaterial because of their good biocompatibility and similarity of chemical composition to natural bones. To increase the mechanical and osteoconductive properties, the granules and spongy type porous bone graft substitutes were prepared by fibrous monolithic process and polyurethane foam replica methods, respectively. The pore sizes obtained using these approaches ranged between 100-600 µm. The cytotoxicity, cellular proliferation, differentiation and ECM deposition on the bone graft substitutes were observed by SEM and confocal microscopy. Moreover, the scaffolds were implanted in the rabbit femur. New bone formation and biodegradation of bone graft were observed through follow-up X-ray, micro-CT analysis and histological findings. After several months (2, 3, 6, 12 and 24 months) of implantation, new bone formation and ingrowths were observed in defect sites of the animal by CaP ceramics and 2 to 3 times higher bone ingrowths were confirmed than that of the normal trabecular bones in terms of total bone volume (BV).


2013 ◽  
Vol 472 (2) ◽  
pp. 767-768 ◽  
Author(s):  
Joerg Friesenbichler ◽  
Werner Maurer-Ertl ◽  
Patrick Sadoghi ◽  
Ulrike Pirker-Fruehauf ◽  
Koppany Bodo ◽  
...  

2008 ◽  
Vol 87A (1) ◽  
pp. 203-214 ◽  
Author(s):  
Jin-Woo Park ◽  
Sang-Ryul Bae ◽  
Jo-Young Suh ◽  
Dong-Hee Lee ◽  
Sang-Hyun Kim ◽  
...  

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