title: Expandable intramedullary nailing and platelet rich plasma to treat long bone non-unions.
abstract: 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.
authors.affiliation: 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.
authors.forename: Olimpio
authors.initials: O
authors.lastname: Galasso
authors.forename: Massimo
authors.initials: M
authors.lastname: Mariconda
authors.forename: Gaetano
authors.initials: G
authors.lastname: Romano
authors.forename: Nicola
authors.initials: N
authors.lastname: Capuano
authors.forename: Luigi
authors.initials: L
authors.lastname: Romano
authors.forename: Bruno
authors.initials: B
authors.lastname: Iannò
authors.forename: Carlo
authors.initials: C
authors.lastname: Milano