Severe periosteal and soft tissue disruption at the time of fracture may result in the formation of an atrophic nonunion. The purpose of this study was to evaluate whether the immediate application of recombinant human bone morphogenetic protein (BMP) to the fracture site could rescue the healing process in this nonunion model. In this atrophic nonunion model, we have demonstrated that the immediate application of BMP at the time of injury may rescue the fracture healing process and prevent the development of atrophic nonunion. Early application of BMP may obviate the need for additional surgical treatment, such as autogenous bone grafting, in situations where there is significant periosteal disruption.

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