Osteogenic protein-1 (bone morphogenic protein-7) combined with various adjuncts in the treatment of humeral diaphyseal nonunions.

A prospective study was conducted to determine the efficacy of using recombinant BMP-7 (rhOP-1) as an adjuvant in the treatment of diaphyseal humeral nonunions. Twenty-three consecutive patients with atrophic humeral diaphyseal nonunions were treated at seven separate institutions. All nonunions were fixed with either a compression plate or an intramedullary nail in conjunction with various bone grafting techniques. Recombinant OP-1 was delivered to the fracture site in a Type I collagen carrier at the time of fixation. All fractures went on to eventual union. There were no serious complications and no adverse reactions to the rhOP-I implant. Our study suggests that rhOP-1 may be a safe and effective adjuvant for the treatment of humeral diaphyseal nonunions.

Persistence of the olecranon physis in baseball players: Results following operative management.

The purpose of this study is to report the results of operative management for pain associated with persistence of the olecranon physis in baseball players. Five maturing adolescent baseball players (4 male and 1 female) with pain associated with persistence of the olecranon physis underwent operative stabilization and autogenous bone grafting with second-stage hardware removal. All 5 patients remained symptomatic after a variable length of conservative management. At a mean follow-up of 32 months (range, 7-84 months), all 5 were satisfied with their results. All returned to or surpassed their previous level of performance. Operative management is recommended for a symptomatic, persistent olecranon physis in the high-demand, skeletally mature overhead athlete in whom conservative management has failed. Operative stabilization with internal fixation and autogenous iliac crest bone grafting results in the resolution of symptoms and a high rate of return to previous throwing performance.