Objectives: 

(1) Evaluate whether initial results from percutaneous treatment of nonunion are reproducible (2) Estimate the relative cost of percutaneous treatment of nonunion versus traditional methods.

Design: 

Retrospective multicentre case series.

Setting: 

Four Level 1 trauma centers.

Patients/Participants: 

Fifty-one patients (34 men and 17 women) with a median age of 51 years (range 14–81) were treated for nonunion at a median of 10 months (range 4–212) from injury.

Intervention: 

Percutaneous strain reduction screws (PSRS).

Main Outcome Measured: 

Union rates and time to union were compared for patients treated in the developing institution versus independent units as well as with previously published results.

Results: 

Forty-five (88%) patients achieved union at a median time of 5.2 months (range 1.0–24.7) confirming the previously published results for this technique. Comparable results were seen between the developing institution and independent units. No patients experienced adverse events beyond failure to achieve union. PSRS seems to offer savings of between £3177 ($4416) to £11,352 ($15,780) per case compared with traditional methods of nonunion surgery.

Conclusions: 

PSRS is a safe, efficacious treatment for long bone nonunion and may be more cost-effective than traditional nonunion treatment methods. The promising initial results of this technique have now been replicated outside of the developing institution.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

---

经皮应力减少螺钉是治疗长骨不愈合的可重复的微创方法

目标： 

(1) 评估经皮治疗骨不连的初步结果是否具有可重复性 (2) 估计经皮治疗骨不连与传统方法的相对成本。

设计： 

回顾性多中心病例系列。

环境： 

四个一级创伤中心。

患者/参与者： 

51 名患者（34 名男性和 17 名女性）中位年龄为 51 岁（范围 14-81 岁），在受伤后中位 10 个月（范围 4-212 个月）接受了骨不连治疗。

干涉： 

经皮减压螺钉 (PSRS)。

测量的主要结果： 

比较了在发展中机构与独立单位治疗的患者的结合率和结合时间，以及之前公布的结果。

结果： 

45 名 (88%) 患者在 5.2 个月的中位时间（范围 1.0-24.7）内实现了愈合，证实了先前公布的该技术的结果。在发展机构和独立单位之间看到了可比的结果。除了未能实现愈合外，没有患者出现不良事件。与传统的骨不连手术方法相比，PSRS 似乎每例可节省 3177 英镑（4416 美元）至 11,352 英镑（15,780 美元）。

结论： 

PSRS 是一种安全、有效的长骨骨不连治疗方法，可能比传统的骨不连治疗方法更具成本效益。该技术的有希望的初步结果现已在开发机构之外复制。

证据等级： 

治疗级别 IV。有关证据级别的完整描述，请参见作者说明。