Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study.
Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study.
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DOI：
10.1007/s12306-015-0378-8
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发表时间：
2015-12-01
影响因子：
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通讯作者：
Chatterjee, K
中科院分区：
文献类型：
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作者：
Malhotra, R;Kumar, V;Chatterjee, K
目的：骨折愈合是一个复杂的生物学过程，依赖于几个系统和局部因素。这些因素中的任何一个受到干扰都可能导致骨折不愈合。这些不结合对生活质量和社会经济方面都有巨大的影响。活化的血小板可释放多种生长因子和分化因子，在骨折愈合过程中发挥重要作用。本研究旨在探讨富血小板血浆治疗长骨骨折不连的疗效。方法：本研究共纳入94例长骨不连患者（胫骨35例，股骨30例，肱骨11例，桡骨4例，尺骨12例，桡骨和尺骨均不连2例）。我们在每个骨不连部位的图像增强器下注射15- 20ml的自体富血小板血浆（约200万个血小板/毫升）。随访4个月，定期进行临床和影像学检查。结果：82例患者术后4个月骨折愈合。2月末x线显示小梁桥化者34例，3月末显示小梁桥化者41例。12例患者在4个月时未表现出任何愈合尝试，并被标记为治疗失败。没有并发症。结论：富血小板血浆治疗骨不连是一种安全有效的治疗方法。富血小板血浆加速骨折愈合的分子机制有待进一步研究。
PURPOSE: 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/mul) 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.CONCLUSION: 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.