| Objective To observe the recent clinical results of platelet-rich plasma (PRP) combined with autologous cancellous bone graft in the treatment of osteonecrosis of the navicular bone of the wrist.Methods Thirty patients with obsolete carpal navicular bone nonunion admitted to 989 Hospital of Joint Service Support Force of Chinese PLA from June 2019 to June 2021 were collected as study subjects and randomly divided into observation group and control group according to a random number table. The observation group (15 patients) used PRP combined with autologous cancellous bone graft for bioreconstruction, and the control group (15 patients) used only autologous cancellous bone graft with internal fixation. The operative time, hospital stay, fracture healing, bone scab grade score, wrist function assessment and postoperative complications of the two groups were compared.Results All 30 patients were followed up after the operation with a follow-up period of 12 months. The fracture healing rate was 93.3% in the observation group and 66.7% in the control group, and the difference between the two groups was statistically significant (P<0.05). The mean operative time was (1.83±0.23) h in the observation group and (1.73±0.30) h in the control group, there was no statistical difference between the two groups (P>0.05). The mean fracture healing time was (16.54±0.74) weeks in the observation group and (20.70±4.73) weeks in the control group, the differences between the two groups were statistically significant(P<0.05). The mean postoperative hospitalization time was (14.27±2.43) d in the observation group and (19.53±6.29) d in the control group, and the differences between the two groups were statistically significant (P<0.05). The bone scab grade score at 4, 8, 12 weeks postoperatively in the observation group were better than that in the control group, the differences between the two groups were statistically significant (P<0.05); the bone scab grade score at 16 weeks postoperatively in the observation group were better than that in the control group, but there was no statistical difference between the two groups (P>0.05). The Mayo score at 6 months postoperative in the observation group was better than that in the control group, and the VAS score was lower than that in the control group, the differences between the two groups were statistically significant (P<0.05); at 12 months after operation, there was no significant difference between the two groups. The postoperative complications were 2 cases in the observation group and 6 cases in the control group, the differences between the two groups were statistically significant (P<0.05).Conclusion Platelet-rich plasma (PRP) combined with autologous cancellous bone grafting for carpal navicular bone nonunion can promote carpal navicular fracture healing, reduce surgery-related complications, and facilitate functional recovery of the wrist joint, with good recent clinical results. |
