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. 2020 May 6;7(3):84-90.
doi: 10.1055/s-0040-1710387. eCollection 2019 Sep.

Comparison of Shape Memory Staple and Gelled Platelet-Rich Plasma versus Shape Memory Staple alone for the Treatment of Waist Scaphoid Nonunion: A Single-Center Experience

Rocco De Vitis  1   2 , Marco Passiatore  1 , Andrea Perna  1 , Giulio Fioravanti Cinci  1 , Giuseppe Taccardo  1   2
Affiliations

Comparison of Shape Memory Staple and Gelled Platelet-Rich Plasma versus Shape Memory Staple alone for the Treatment of Waist Scaphoid Nonunion: A Single-Center Experience

Rocco De Vitis et al. Joints. .

Abstract

Purpose The aim of this study was to analyze the results of two different methods of surgical treatment of waist scaphoid nonunions (SNUs). We retrospectively analyzed data from 87 patients referred to our department from January 2010 to December 2017 who were surgically treated for waist SNU. Methods The mean period of time passed from trauma was 11.2 (±5.6) months. Patients were divided into two groups based on surgical treatment received: volar exposure osteosynthesis with shape memory staple (SMS) (group A) and volar exposure osteosynthesis with SMS and gelled platelet-rich plasma (GPRP) application at the bone defect level (group B). A cast (thumb excluded) was maintained for 4 weeks. Healing was checked clinically (pain, QuickDASH [Disabilities of the Arm, Shoulder, and Hand] score, Mayo Wrist Score) and radiologically (standard X-ray). Results Union was achieved in 40 patients in group A (95.2%) and in all patients in group B (45 patients; 100%). A statistically significant difference was observed in the improvement of the Mayo Wrist Score, QuickDASH score, and pain (measured through the visual analog scale) after 3 months from surgery ( p = 0.02). Conclusion SMS is effective in treating waist SNU at more than 6 months from trauma. GPRP application can improve bone healing and upper limb function. Level of Evidence This is a retrospective observational Level III study.

Keywords: platelet-rich plasma; scaphoid; scaphoid nonunion; shape memory staple; staple.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Production of gelled platelet-rich plasma.
Fig. 2
Fig. 2
Surgical treatment. ( A ) Surgical exposure. ( B ) Debridement at the nonunion site is performed. Two K-wires are inserted to allow the accommodation of the staple. ( C ) The staple fixes the bone. ( D ) Autologous gelled platelet-rich plasma (GPRP) is identified with a label. ( E ) GPRP is gently inserted to fill the gap.
Fig. 3
Fig. 3
A 32-year-old male patient with scaphoid nonunion in the left hand, with time passed from trauma of 12 months. ( A–C ) Preoperative radiographs. ( D,E ) Postoperative radiographs (2 months after surgery).
Fig. 4
Fig. 4
Clinical results after 2 months (the same patient as in Fig. 3 ).
See this image and copyright information in PMC

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