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Abstract Objective To investigate the clinical effect of intra-articular injection of intra-articular Platelet-Rich Plasma (PRP) combined with open reduction and internal fixation in the treatment of acute trans-scaphoid perilunate dislocation (TSPD).Methods Between July 2016 and July 2018，18 TSPD patients treated with PRP injection after open reduction and internal fixation were selected as the PRP group.There were 12 males and 6 females，with an average age of (34.8±11.3)years(range，25~53 years).The causes of injury inclued as follows：8 cases of falling，6 cases of machine impact，4 cases of violent injury in traffic accidents.Between June 2014 and June 2016，18 patients with TSPD who underwent open reduction and internal fixation in our department were selected as the control group，including 10 males and 8 females，with an average age of (32.5±9.2)years(range，23~51 years).The causes of injury inclued as follows：7 cases of falling，6 cases of machine impact，5 cases of violent injury in traffic accidents.According to Herbert’s classification，all fractures in injury were type B4.Before operation and at last follow-up，Krimmer wrist score，imaging results，complications，disability of arm shoulder and hand (DASH) and Mayo function score were compared between the two groups.Results All patients were followed up with an average of (32.5±7.8)months (range，24~48 months).In the PRP group，the Krimmer score was significantly higher than that in the control group (P＜0.01).In the PRP group，the Krimmer wrist function was excellent in 16 cases，good in 1 case，fair in 1 case，and poor in 0 case，and the excellent and good rate of 94.44%.In the control group，10 cases were excellent，3 cases were good，3 cases were fair，and 2 cases were poor，and the excellent and good rate was 72.22%；All patients in the PRP group had no necrosis of the scaphoid and lunate at last follow-up，and there was no infection and traumatic arthritis during the follow-up.In the control group，4 cases result in avascular necrosis of scaphoid，3 patients had traumatic arthritis，and 1 patient had postoperative wound infection.There was significant difference in the incidence of complications between the two groups (P＜0.01).At last follow-up，the average DASH score was (12.83±2.27) in PRP group and (49.20±5.41) in control group.The difference was statistically significant (P＜0.05).The Mayo wrist score of the two groups was improved after operation，and the Mayo wrist score of PRP group was higher than that of the control group at the last follow-up，the difference was statistically significant (P＜0.05).Conclusion PRP in the treatment of TSPD can promote fracture healing，repair articular cartilage damage and reduce the incidence of post-operative complications，so as to improve the quality of life，which may have better application values.
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