title: Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study.
abstract: OBJECTIVE
  Fracture union is a complex biological process, which depends upon several systemic and local factors. Disturbance of any of these factors may lead to nonunion of the fracture. These nonunions have a huge impact on quality of life as well as socioeconomical aspects. The platelets on activation release a number of growth factors and differentiation factors, which play important role in fracture healing. This study aimed to look for efficacy of platelet-rich plasma in the treatment of established fracture nonunions of long bones.
  
  
  METHODS
  A total of 94 patients with established nonunion of long bone (35 tibia, 30 femur, 11 humerus, 4 radius, 12 ulna, 2 with both radius and ulna) were included in this study. We injected 15-20 ml of autologous platelet-rich plasma (>2,000,000 platelets/μl) under image intensifier at each nonunion site. The fracture union was evaluated clinically and radiologically regularly at monthly interval till 4 months.
  
  
  RESULTS
  Eighty-two patients had their fracture united at the end of 4 months. Thirty-four patients showed bridging trabeculae on X-rays at the end of 2 months, while 41 patients showed bridging trabeculae at the end of third month. Twelve patients did not show any attempt of union at 4 months and were labeled as failure of treatment. There were no complications.
  
  
  CONCLUSIONS
  Platelet-rich plasma is a safe and effective treatment for the treatment of nonunions. More studies are needed to look into molecular mechanism of this fracture healing acceleration by platelet-rich plasma.
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: R
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: V
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India. drbhavukgarg@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Garg
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: V
authors.initials: V
authors.lastname: Jain
authors.affiliation: Department of Transfusion Medicine, AIIMS, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Coshic
authors.affiliation: Department of Transfusion Medicine, AIIMS, New Delhi, India.
authors.forename: K
authors.initials: K
authors.lastname: Chatterjee
mesh_terms: D005260:Female; D005264:Femoral Fractures / Q000628:therapy; D005500:Follow-Up Studies; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D006810:Humeral Fractures / Q000628:therapy; D007279:Injections, Subcutaneous; D008297:Male; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D011788:Quality of Life; D011885:Radius Fractures / Q000628:therapy; D013978:Tibial Fractures / Q000628:therapy; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000628:therapy
keywords: Femur; Humerus; Nonunion; Platelet-rich plasma (PRP); Radius; Tibia