Results of the use of platelet rich plasma in the treatment of delayed union of long bones.

BACKGROUND The aim of this study was to assess the efficacy of platelet rich plasma in the treatment of delayed union of long bones according to fracture location, the time between the fracture and PRP administration, and the type of surgical fixation. MATERIAL AND METHODS A total of 1620 patients with long bone fractures were treated surgically at the Department of Traumatology of the Military Medical Institute in Warsaw between 2009 and 2012. Delayed union was diagnosed in 158 (9.75%) patients. Our analysis includes 132 patients (26 persons were lost to follow-up), with 53 women (40.15%) and 79 men (59.85%) aged 16 to 85 years (mean age 41). RESULTS Bone union after PRP administration was found in 108 patients (81.8%) while the method proved ineffective in 24 patients (18.2%). It was most effective in patients with delayed union of the proximal tibia treated surgically by open reduction and plate fixation (100%), on average 3.5 months after PRP administration. The lowest efficacy was observed in patients with delayed union of the proximal humerus treated surgically by open reduction and plate fixation (63.64%), on average 3.2 months after PRP administration. CONCLUSIONS 1. PRP is effective in the treatment of delayed union of long bones. 2. The highest incidence of delayed bone union was seen after the treatment of long bone fractures by open reduction and plate fixation whereas the lowest number of such cases was observed in patients treated by closed reduction with intramedullary nail fixation. 3. The mean time between surgical treatment and diagnosis of delayed bone union followed by PRP administration was 4.05 months.