title: Autologous platelet lysates local injections for treatment of tibia non-union with breakage of the nickelclad: a case report.
abstract: BACKGROUND
  Nonunions of the tibia represent challenging orthopedic problems, which require the surgeon to analyze numerous factors and choose an appropriate treatment. This article presents a case report of tibia and fibula fracture patient who failed the internal fixation surgery and successfully recovered after one course of percutaneous autologous platelet lysates injection.
  
  
  METHODS
  The patient received an internal nickelclad breakage at 9 months post-surgery but reluctant to accept a second surgery, then autologous platelet lysates (APL) injection which is a less invasive method was recommended. The injections were carried once a week for three times. Radiologic evaluation was conducted every month until recovery.
  
  
  RESULTS
  To the best of our knowledge, this is the first reported case of tibia delayed union with breakage of the plate resolved with APL injection. Improved clinical evidence was observed at 4 and 6 months after injection. The patient got good bony union at 8 months post-injection. The patient didn't feel any discomfort postinjection, no complications such as infection, refracture etc. were observed.
  
  
  CONCLUSIONS
  APL percutaneous injection could be a new therapeutic option for the treatment of nonunion or delayed healing fractures.
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Hong-Jiang
authors.initials: HJ
authors.lastname: Jiang
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Xun-Xiang
authors.initials: XX
authors.lastname: Tan
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Hai-Yang
authors.initials: HY
authors.lastname: Ju
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Su
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Wei
authors.identifier: 0000-0001-5575-7017
authors.initials: W
authors.lastname: Yan
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Xiu-Gang
authors.initials: XG
authors.lastname: Song
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Li-Wu
authors.initials: LW
authors.lastname: Qin
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: Chang-Jun
authors.initials: CJ
authors.lastname: Ju
authors.affiliation: Zhejiang Xingyue Biotechnology Co. Ltd, Hangzhou, 311121 China.
authors.forename: Ling-Shuang
authors.initials: LS
authors.lastname: Wang
authors.affiliation: Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Wendeng, 264400 Shandong China.
authors.forename: De-Bao
authors.initials: DB
authors.lastname: Zou
keywords: Autologous platelet lysates; Non-union; Percutaneous injections; Tibia and fibula fracture