Pecin Marko, Stokovic Nikola, Ivanjko Natalia, Smajlovic Ana, Kreszinger Mario, Capak Hrvoje, Vrbanac Zoran, Oppermann Hermann, Maticic Drazen, Vukicevic Slobodan
Clinics for Surgery, Orthopedics and Ophthalmology, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia.
Laboratory for Mineralized Tissues, Centre for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, Croatia.
Bone Rep. 2021 Feb 25;14:100759. doi: 10.1016/j.bonr.2021.100759. eCollection 2021 Jun.
Management of large segmental defects is one of the most challenging issues in bone repair biology. Autologous bone graft substitute (ABGS) containing rhBMP6 within autologous blood coagulum (ABC) with synthetic ceramics is a novel biocompatible therapeutic solution for bone regeneration.
A 2-year old dog was brought to the veterinary clinics due to pain and bleeding from the right front leg after being unintendedly hit by a gunshot. Radiological examination revealed a large, 3 cm long multisegmental defect of the humerus on the right front leg with a loss of anatomical structure in the distal portion of the bone. The defect was treated surgically and an external fixator was inserted to ensure immobilization. Complete lack of bone formation 3 months following surgery required a full reconstruction of the defect site with a novel ABGS (rhBMP6 in ABC with ceramic particles) to avoid front leg amputation. The healing was then followed for the next 16 months. The callus formation was observed on x-ray images 2 months following ABGS implantation. The bone segments progressively fused together leading to the defect rebridgment allowing removal of the external fixator by 4 months after the reconstruction surgery. At the end of the observation period, the function of the leg was almost fully restored while analyses of the humeral CT sections revealed restoration and cortices rebridgment with a renewal of uniform medullary canal including structural reconstruction of the distal humerus.
This large humeral gunshot segmental defect of the front leg in a dog was saved from amputation inducing bone regeneration using a novel ABGS osteoinductive device containing BMP6 in ABC.
大段骨缺损的处理是骨修复生物学中最具挑战性的问题之一。含重组人骨形态发生蛋白6（rhBMP6）的自体骨移植替代物（ABGS）与合成陶瓷混合于自体血凝块（ABC）中，是一种用于骨再生的新型生物相容性治疗方案。
一只2岁的狗因意外被枪击后右前腿疼痛和出血被带到兽医诊所。放射学检查显示右前腿肱骨有一个3厘米长的大的多节段缺损，骨远端部分解剖结构丧失。对该缺损进行了手术治疗，并插入外固定器以确保固定。术后3个月完全没有骨形成，需要用一种新型的ABGS（含陶瓷颗粒的ABC中的rhBMP6）对缺损部位进行完全重建，以避免右前腿截肢。随后对愈合情况进行了16个月的跟踪观察。ABGS植入后2个月，在X线图像上观察到骨痂形成。骨段逐渐融合在一起，导致缺损重新桥接，重建手术后4个月可拆除外固定器。在观察期结束时，腿部功能几乎完全恢复，而肱骨CT切片分析显示恢复良好，皮质重新桥接，髓腔均匀更新，包括肱骨远端的结构重建。
一只狗前腿肱骨的大的枪伤节段性缺损通过使用一种新型的含BMP6的ABGS骨诱导装置诱导骨再生，避免了截肢。
