title: Platelet gel supplementation in long bone nonunions treated by external fixation.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the use of previously frozen, thawed platelet gel supplementation to accelerate the healing of long bone nonunions treated by external fixation.
  
  
  METHODS
  Prospective case series with historical controls.
  
  
  METHODS
  University Hospital.
  
  
  METHODS
  Twenty patients affected by tibial, humeral, or forearm atrophic nonunions were treated by percutaneous stabilization with unilateral external fixators and injection of autologous platelet gel. The healing time was compared to the result obtained in a historical control group treated without platelet gel supplementation.
  
  
  METHODS
  Consolidation rate and radiographic healing time of nonunions in the 2 groups were assessed by independent blinded observers. The nonunion was judged to be healed when bridging callus formation on both radiographic views was observed on at least 3 of 4 cortices.
  
  
  RESULTS
  The healing rate of nonunion was 90% (18/20) in platelet gel cases and 85% (17/20) in controls, respectively (P = 0.633). The mean time until radiographic consolidation in nonunions supplemented with platelet gel (147 +/- 63 days) was not different to the result in the control group (153 +/- 61 days; P = 0.784). Analyzing the mean healing time for separate segments, no differences were noted between study and control group-that is, tibia: 112 +/- 43 and 130 +/- 5 days, respectively (P = 0.382); humerus, 225 +/- 36 and 202 +/- 70 days, respectively (P = 0.530).
  
  
  CONCLUSIONS
  The present study failed to show the clinical usefulness of isolated percutaneous platelet gel supplementation in long bone nonunions treated by external fixation; however, caution should be exercised in interpreting this result because the actual numbers are small and the statistical power is limited.
authors.affiliation: Federico II University, Department of Orthopaedic Surgery, Naples, Italy. maricond@unina.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Mariconda
authors.forename: Francesco
authors.initials: F
authors.lastname: Cozzolino
authors.forename: Andrea
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Elio
authors.initials: E
authors.lastname: D'Agostino
authors.forename: Antonio
authors.initials: A
authors.lastname: Bove
authors.forename: Carlo
authors.initials: C
authors.lastname: Milano
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016267:External Fixators; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome