title: Early experience and results of bone graft enriched with autologous platelet gel for recalcitrant nonunions of lower extremity.
abstract: BACKGROUND
  Refractory nonunions of the tibia or femur are physically and mentally devastating conditions for the patients, and the treatment is challenging for orthopedic surgeons. The goal of this study was to assess the feasibility and outcome of surgical treatment in recalcitrant nonunions of a lower extremity with bone graft enriched with autologous platelet gel (APG).
  
  
  METHODS
  Twelve patients with four femoral and eight tibial atrophic nonunions after multiple prior procedures were included. All of them were treated with the bone grafting procedures with autograft complex enriched with APG. They were evaluated with radiographs, bone mineral density for bony healing process, and the Short-Form 36 Health Survey for functional outcome.
  
  
  RESULTS
  Of the 12 patients, 11 healed at an average of 19.7 weeks after the first attempt and 1 healed after the second attempt at 21 weeks. The bone mineral density continued to increase steadily from early healing to the remodeling phase. Functional status was greatly improved at an average follow-up of 32.4 months.
  
  
  CONCLUSIONS
  The results of this preliminary study implied the possible potential of bone graft enriched with APG in the treatment of recalcitrant nonunions of the lower extremity. More research is necessary to clarify its role in augmentation of bone graft to enhance healing of nonunion.
authors: Department of Orthopaedics and Traumatology, Taipei Veterens General Hospital, Taipei, Taiwan, Republic of China. chiangcc@vghtpe.gov.tw
authors: Chao-Ching
authors: CC
authors: Chiang
authors: Chen-Yao
authors: CY
authors: Su
authors: Ching-Kuei
authors: CK
authors: Huang
authors: Wei-Ming
authors: WM
authors: Chen
authors: Tain-Hsiung
authors: TH
authors: Chen
authors: Yun-Hsuan
authors: YH
authors: Tzeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D016025:Bone Transplantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D005782:Gels; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D005782:Gels