Nonunions treated with autologous preparation rich in growth factors.
OBJECTIVE
To evaluate the clinical safety and efficacy of using a biologic technology known as preparation rich in growth factors (PRGF) for the treatment of nonhypertrophic nonunion.


METHODS
The design of the study was a retrospective case series.


METHODS
The private practice was in 2 centers.


METHODS
There were 15 patients with a total of 16 aseptic nonunions, 12 diaphyseal and 4 supracondylar, diagnosed as nonhypertrophic. The mean time since prior surgical treatment was 21 months (9-46 months).


METHODS
Supracondylar and diaphyseal nonunions followed surgical fixation with condylar plating or intramedullary nailing, whereas a composite biomaterial created by mixing PRGF with bone allograft was applied. The area was then covered with autologous fibrin membranes. Stable nonunions were treated with repeated percutaneous injections of PRGF; this minimally invasive procedure was also applied if delayed healing was suspected after surgical treatment.


METHODS
Radiographic union using radiographic views was taken in 2 planes. Clinical outcome evaluated pain, motion at the fracture site upon manual stress testing, and recovery of range of motion.


RESULTS
All nonunions treated operatively healed after a single procedure, even though additional PRGF had to be injected in 2 patients. Two of 3 stable nonunions achieved healing only after repeated percutaneous PRGF injections. The mean time from surgery and/or PRGF application to union was 4.9 months (2-8 months). Complications associated with the described procedure were not observed.


CONCLUSIONS
This study, although uncontrolled, shows that PRGF technology is clinically safe and can enhance the healing of nonhypertrophic nonunions.
Sanchez
Mikel
M
Unidad de Cirugia Artroscópica UCA, Clínica USP-La Esperanza, Vitoria, Spain.
Anitua
Eduardo
E
Cugat
Ramon
R
Azofra
Juan
J
Guadilla
Jorge
J
Seijas
Roberto
R
Andia
Isabel
I
D000328:Adult; D000368:Aged; D001858:Bone Nails; D016025:Bone Transplantation; D003131:Combined Modality Therapy; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D055815:Young Adult
D036341:Intercellular Signaling Peptides and Proteins