Pseudoartrosi sottotrocanterica in osteogenesi imp

Authors: G M Calori E Mazza L Tagliabue M Colombo C Ripamonti

Publish Date: 2011/01/21

Volume: 121, Issue: 2-3, Pages: 9-10

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Abstract

A 41yearsold patient came to our observation for a subtrochanteric nonunion after a femural fracture the patient was affected with osteogenesis imperfecta type III associated with severe skeletal malformations such as convex chestlumbar scoliosis cardiomegaly and pelvic deformity Moreover she presented a severe hypometria of the contralateral leg about 20 cm associated with an important extrarotation and varism of the residual femural neck and clinodactyly Surgical treatment consisted in the removal of the old broken fixation plate pathological tissue cruentation lateral 35° cuneiform resection After a correct reduction we completed the fixation with a new osteosynthesis using AO LCP Synthes plate with trochanteric hooks and 8 screw than we implanted growth factors rhBMP7 autologous mesenchymal cells and a double massive allogenic bone graft The postoperative course was regular After 60 days a radiograph showed an initial healing of the fracture Clinically functional recovery of the operated limb was good allowing the patient good mobility After 3 months a great healing progression was evident on CT control scans with stable fixation and a correct alignmentNonunions are always challenging for the orthopaedic surgeon frequently leading to severe and disabling deformity this is much more true in this complex case with a patient affected by osteogenesis imperfecta Biotechnology namely the use of human recombinant morphogenetic proteins rhBMP7 with autologous mesenchymal cells implant represents not only a valid biological supplementation already validated by international studies but also a big opportunity for healing

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