Abstract
Case: A 49-year-old male smoker with no comorbidities presented with a tibial plafond fracture treated operatively. Complications resulted to an infected nonunion, requiring 20 surgeries over 3 years. Examination revealed a malaligned hypertrophic nonunion with osteomyelitis requiring extensive reconstruction. Deformity was corrected with a Taylor Spatial Frame, followed by the implantation of a biomimetic hematoma scaffold delivering recombinant human bone morphogenetic protein-2 (rhBMP-2) into the debrided defect, alongside Cerement G to control infection. At 6 months, the patient achieved complete bony union without recurrence of infection, allowing Taylor Spatial Frame removal. Conclusion: The biomimetic hematoma enabled successful healing using a low-dose rhBMP-2, highlighting its potential for treatment-resistant nonunions.
| Original language | English (US) |
|---|---|
| Article number | e25.00267 |
| Journal | JBJS Case Connector |
| Volume | 15 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2025 |
Keywords
- CERAMENT G
- Gram-negative bacteria
- Gram-positive bacteria
- ORIF, TSF
- S. aureus
- biomimetic hematoma
- bone graft
- bone healing
- infection
- male
- nonunion
- osteomyelitis
- rhBMP-2
- scaffold
- tibial plafond fracture
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
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