Expandable intramedullary nailing and platelet rich plasma to treat long bone non-unions.
BACKGROUND
Roentgenographic and functional outcomes of expandable self locking intramedullary nailing and platelet rich plasma (PRP) gel in the treatment of long bone non-unions are reported.


METHODS
Twenty-two patients suffering from atrophic diaphyseal long bone non-unions were enrolled in the study. Patients were treated with removal of pre-existing hardware, decortication of non-union fragments, and fixation of pseudoarthrosis with expandable intramedullary nailing (Fixion, Disc'O Tech, Tel Aviv, Israel). At surgery, PRP was placed in the pseudoarthrosis rim.


RESULTS
The thirteen-month follow-up showed 91% (20/22 patients) of patients attaining bony union. The average time to union was 21.5 weeks. No infection, neurovascular complication, rotational malalignment, or limb shortening >4 mm were observed. The healing rate of non-unions was comparable to that observed in previous studies but with a lower complication frequency.


CONCLUSIONS
The combined use of self locking intramedullary nailing and PRP in the management of atrophic diaphyseal long bone non-unions seems to produce comparable results with less complications than previously reported. Further data are warranted to investigate the single contribution of PRP gel and Fixion nail.
Galasso
Olimpio
O
Cattedra ed Unità Operativa Complessa di Ortopedia e Traumatologia, Università degli Studi "MagnaGraecia" di Catanzaro, Campus "S. Venuta", V.le Europa, 88100, Germaneto Catanzaro, Italy, golimpiogo@hotmail.com.
Mariconda
Massimo
M
Romano
Gaetano
G
Capuano
Nicola
N
Romano
Luigi
L
Iannò
Bruno
B
Milano
Carlo
C