title: Effects of Platelet Rich Plasma on Healing Rate of Long Bone Non-union Fractures: A Randomized Double-Blind Placebo Controlled Clinical Trial.
abstract: OBJECTIVE
  To determine the effects of platelet rich plasma PRP on healing rates of long bone non-union fracture.
  
  
  METHODS
  This was a randomized double-blind placebo controlled clinical trial being performed in a 12-month period. We included 75 adult (>18 years) patients suffering from long bone (Femur, Tibia, Humerus and Ulna) non-union fracture who were randomly assigned to receive 5mL PRP (n=37) or 5mL normal saline as placebo (n=38) in the site of fracture after intramedullary nailing or open reduction and internal fixation (ORIF) along with autologous bone graft. Patients were followed each 45 days till 9 months and were evaluated both clinically and radiologically in each visit. The healing rate, failure rate, incidence of infection, mal-union and limb shortening were recorded and compared between groups after 9 months of follow-up.
  
  
  RESULTS
  The healing rate was significantly higher in PRP group compared to placebo (81.1% vs. 55.3%; p=0.025). The limb shortening was significantly higher in those who received placebo (2.61±1.5 vs. 1.88±1.2mm; p=0.030). Injection of PRP was also associated with lower pain scores ( p=0.003) and shorter healing duration ( p=0.046). The surgical site infection ( p=0.262) and mal-union rate ( p=0.736) were comparable between groups.
  
  
  CONCLUSIONS
  Application of PRP along with autologous bone graft in the site of non-union of long bone after intramedullary nailing or ORIF results in higher cure rate, shorter healing duration, lower limb shortening and less postoperative pain. Higher infection rate might be a complication of PRP application.
  
  
  BACKGROUND
  This trial is registered with the Iranian Clinical Trials Registry (IRCT201208262445N1; www.irct.ir).
authors.affiliation: Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.affiliation: Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Shahrezaei
authors.affiliation: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Dehghankhalili
keywords: Intramedullary nailing; Long bone fracture; Non-union; Open reduction and internal fixation (ORIF); Platelet rich plasma (PRP)