Platelet-rich plasma versus exchange intramedullary nailing in treatment of long bone oligotrophic nonunions

• Published in: European journal of orthopaedic surgery & traumatology Vol. 28; no. 1; pp. 131 - 137
• Main Authors: Duramaz, Altuğ, Ursavaş, Hüseyin Tamer, Bilgili, Mustafa Gökhan, Bayrak, Alkan, Bayram, Berhan, Avkan, Mustafa Cevdet
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 2018; Springer Nature B.V
• Subjects: Adult; Diaphyses - injuries; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - therapy; Fracture Fixation, Intramedullary; Fracture Healing; Fractures, Malunited - diagnostic imaging; Fractures, Malunited - therapy; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article • LOWER LIMB - FRACTURES; Platelet-Rich Plasma; Postoperative period; Surgical Orthopedics; Tibial Fractures - diagnostic imaging; Tibial Fractures - therapy; Time Factors; Traumatic Surgery; Visual Analog Scale; Exchange intramedullary nailing; Bone healing; Long bone nonunion; Platelet-rich plasma
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-017-2024-7

Introduction The aim of the study was to evaluate the effects of platelet-rich plasma on healing rates and healing time in the treatment of long bone nonunions treated by an intramedullary nail previously. Materials and methods Between August 2008 and January 2012, 14 consecutive patients who were treated for long bone nonunions with percutaneous platelet-rich plasma application (PRP) were included in the study. The control group included 15 consecutive patients who were treated with exchange intramedullary nailing (EIN). In the postoperative period, all patients were controlled in every 2 weeks clinically and in every 4 weeks radiologically. Patients were evaluated with visual analog scale (VAS) in preoperative and postoperative periods. Results The mean healing time was shorter in PRP group as 16.71 ± 2.4 weeks compared with that of 19.07 ± 3.67 weeks in EIN group ( p  = 0.053). At the end of the follow-up, the union is achieved in 92.8% of the cases in PRP group. This ratio was 80% in control group. The mean VAS values in preoperative and postoperative periods were not statistically significant in both groups ( p  > 0.05). When PRP and control groups were evaluated individually, the postoperative VAS was lower than that of preoperative VAS in both groups ( p  = 0.0001 and p  = 0.0001, respectively). Conclusion Percutaneous PRP application significantly affected union rate, but no significant difference found when compared to EIN in the treatment of oligotrophic nonunions after intramedullary nailing of long bone fractures. PRP can be applied as a minimally invasive and safe method of saving resources in medical care instead of EIN.