Non-union Treatment in the arm, wrist, and fingers: A Multicenter Retrospective Study Contrasting Conventional Treatment with the Allogeneic Cortical Bone Screw (Shark Screw®)

Abstract

Introduction: The cause of pseudarthrosis is the interaction of various biological and biomechanical factors with systemic and local interactions. Successful therapy consists of a combination of optimizing mechanical stability and activating biological factors. The conventional method for treating non-union is debridement and stabilization with metal hardware. But it leads to complications and a potential second operation for hardware removal. The human allogeneic cortical bone screw (Shark Screw®) provides a close contact between allograft and host bone, which is required for revascularisation and bone healing. The Shark Screw® merges human cortical bone properties with screw stability, addressing non-union surgery principles by integrating mechanical and biological aspects. Material and Methods: The retrospective-multi-center study included 31 patients, 11treated with the conventional method(metal hardware ± graft) and 20 patients with the Shark Screw® (±graft). Patient demographics, non-union location, autograft and/or allograft use, follow-up time, complications, union-rate, time-to-union and time-to-return to work were recorded. Results: Follow-up was 17 months in the conventional group and 12 months in the Shark Screw® group. The union rate was 72.7% in the conventional group and 95.0% in the Shark Screw® group. Time to union was significantly shorter in the Shark Screw® group with 12 weeks in comparison to 39 weeks in the conventional group. Conclusion The Shark Screw® presents a reliable option for treating non-unions in the shoulder, forearm, hand, and fingers. It demonstrates a low complication rate. The human allogeneic cortical bone screw (Shark Screw®) combines both stability and biology with a single transplant. The socioeconomic effect is another advantage using the Shark Screw®. Level of evidence: III