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CC BY-NC-ND 4.0 · Joints 2019; 07(03): 084-090
DOI: 10.1055/s-0040-1710387
Original Article

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   Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2   Università Cattolica del Sacro Cuore, Rome, Italy
,
Marco Passiatore  ‡   *
1   Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Andrea Perna 
1   Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Giulio Fioravanti Cinci 
1   Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Giuseppe Taccardo 
1   Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2   Università Cattolica del Sacro Cuore, Rome, Italy
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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

scaphoid - staple - scaphoid nonunion - shape memory staple - platelet-rich plasma

* These authors contributed equally to the study.




Publikationsverlauf

Eingereicht: 04. Juni 2019

Angenommen: 04. April 2020

Artikel online veröffentlicht:
06. Mai 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

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