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J Orthop Traumatol. 2008 Sep;9(3):129-34. doi: 10.1007/s10195-008-0021-7. Epub 2008 Jul 4.

Expandable intramedullary nailing and platelet rich plasma to treat long bone non-unions.

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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,



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.


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.


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.


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.

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