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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. Jun 16, 2026; 14(17): 119557
Published online Jun 16, 2026. doi: 10.12998/wjcc.v14.i17.119557
Bone morphogenetic protein alone vs in combination with bone graft in management of non-union of tibia fractures
Raja Muhammad Mussab, Sharjeel Khan, Hadia Javed, Shehanshah Muhammad Arqam, Shehzadi Rimsha, Safeer Ahmad Javaid
Raja Muhammad Mussab, Sharjeel Khan, Hadia Javed, Shehanshah Muhammad Arqam, Shehzadi Rimsha, Safeer Ahmad Javaid, Orthopaedics and Trauma, Jinnah Postgraduate Medical Centre, Karachi 75510, Sindh, Pakistan
Author contributions: Mussab RM, Khan S, Javed H, Arqam SM, Rimsha S and Javaid SA designed the research study; Mussab RM, Khan S, Javed H and Arqam SM performed the research; Mussab RM, Khan S, Rimsha S and Javaid SA contributed to data collection and data interpretation; Mussab RM, Khan S ,Rimsha S, Javaid SA and Javed H wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: Ethical approval was granted by the Institutional Review Board of Jinnah Postgraduate Medical Centre.
Informed consent statement: Signed informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Raja Muhammad Mussab, Orthopaedics and Trauma, Jinnah Postgraduate Medical Centre, Rafiqui Shaheed Road, Karachi 75510, Sindh, Pakistan. mussabafaq@hotmail.com
Received: February 2, 2026
Revised: March 8, 2026
Accepted: April 9, 2026
Published online: June 16, 2026
Processing time: 124 Days and 7.6 Hours
Core Tip

Core Tip: Non-union of tibial fractures remains a significant challenge in orthopaedic trauma practice, often associated with prolonged morbidity and a substantial economic burden on healthcare systems. Bone morphogenetic proteins (BMPs) have emerged as a promising biological agent in fracture healing; however, their use in clinical practice, either alone or in combination with bone grafting techniques, remains variable and sometimes controversial due to cost-effectiveness and clinical outcomes. Our study directly compares the outcomes of BMP use alone vs in combination with autologous bone grafts in managing tibial non-unions. This manuscript contributes provides valuable insights that can aid clinical decision-making, particularly in resource-limited settings where the optimal use of biologics must be balanced against surgical and economic factors.

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