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All Journal Jurnal Ilmiah Kesehatan Masyarakat Health & Medical Sciences
Andika Prasetyo Arifin
QADR Hospital
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Autologous Bone Graft Versus Bone Morphogenetic Protein Augmentation for Comminuted Midshaft Femoral Fractures: A Systematic Review Andika Prasetyo Arifin; M Yogi Alamsyah; Arimurti Pratianto; Rheza Fabianto Sebastian
Health & Medical Sciences Vol. 3 No. 4 (2026): August
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/phms.v3i4.677

Abstract

Comminuted midshaft femoral fractures (AO/OTA 32-C2/C3) are complex injuries associated with extensive bone fragmentation, severe soft-tissue damage, and elevated risks of delayed union or nonunion. This systematic review, conducted in accordance with PRISMA guidelines, compared the efficacy and safety of autologous bone grafting (ABG) versus recombinant bone morphogenetic protein (BMP) augmentation as adjuncts to surgical fixation. Comprehensive searches of PubMed, Embase, and Cochrane databases identified twelve comparative studies involving patients treated with internal fixation plus biological enhancement. Primary outcomes included radiographic union rates, time to union, complications, functional recovery, and cost-effectiveness. Risk of bias was assessed using the ROBINS-I tool. Both ABG and BMP achieved high union rates (92% versus 90%), with BMP linked to an approximate two-week reduction in healing time. Substantial heterogeneity across studies, however, precluded definitive conclusions. ABG provided reliable results but was associated with donor-site morbidity in nearly one-fifth of patients. BMP avoided harvest-related complications yet increased risks of heterotopic ossification and soft-tissue edema while incurring significantly higher costs without proven superiority in preventing nonunion or reoperation. In conclusion, both ABG and BMP offer effective biological support for these fractures. Treatment selection should be individualized according to patient characteristics, fracture severity, complication profiles, and resource availability; routine BMP use is not currently justified.
A Four-Months-Neglected Anterior Shoulder Dislocation Treated with Open Reduction and Internal Fixation: A Case Report Andika Prasetyo Arifin; Sammy Saleh Al Huraiby
SEHATMAS: Jurnal Ilmiah Kesehatan Masyarakat Vol. 5 No. 3 (2026): Juli 2026
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/sehatmas.v5i3.8030

Abstract

Neglected anterior shoulder dislocation (NASD) is an uncommon yet clinically demanding condition, largely because diagnosis and treatment are frequently delayed. Patients often develop secondary problems such as glenoid bone loss, capsular contracture, and ongoing instability, all of which call for a carefully chosen surgical strategy. This report describes the management of a chronic case using open reduction and internal fixation. A 25-year-old man was seen after sustaining an anterior shoulder dislocation that had remained untreated for four months. Clinical examination combined with plain radiographs established the diagnosis. Through a deltopectoral approach the glenohumeral joint was reduced under direct vision and stabilized with two 2.0-mm K-wires. At the two-week review both clinical examination and repeat radiographs confirmed that the joint had been restored to an anatomic position with good stability. The patient had no appreciable sensory or motor deficit in the limb, and neurovascular function remained intact. These early results indicate that open reduction and internal fixation can reliably address chronic NASD and reduce the risk of recurrent instability. Nevertheless, longer-term surveillance is required to confirm lasting joint stability and to detect any late complications that may develop.
Co-Authors Arimurti Pratianto M Yogi Alamsyah Rheza Fabianto Sebastian Sammy Saleh Al Huraiby