Duramaz Altuğ, Ursavaş Hüseyin Tamer, Bilgili Mustafa Gökhan, Bayrak Alkan, Bayram Berhan, Avkan Mustafa Cevdet
Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Atatürk Education and Research Hospital, İzmir Katip Çelebi University, Basın St., 35360, Karabağlar, Izmir, Turkey.
Eur J Orthop Surg Traumatol. 2018 Jan;28(1):131-137. doi: 10.1007/s00590-017-2024-7. Epub 2017 Aug 1.
The aim of the study was to evaluate the effects of platelet-rich plasma on healing rates and healing time in the treatment of long bone nonunions treated by an intramedullary nail previously.
Between August 2008 and January 2012, 14 consecutive patients who were treated for long bone nonunions with percutaneous platelet-rich plasma application (PRP) were included in the study. The control group included 15 consecutive patients who were treated with exchange intramedullary nailing (EIN). In the postoperative period, all patients were controlled in every 2 weeks clinically and in every 4 weeks radiologically. Patients were evaluated with visual analog scale (VAS) in preoperative and postoperative periods.
The mean healing time was shorter in PRP group as 16.71 ± 2.4 weeks compared with that of 19.07 ± 3.67 weeks in EIN group (p = 0.053). At the end of the follow-up, the union is achieved in 92.8% of the cases in PRP group. This ratio was 80% in control group. The mean VAS values in preoperative and postoperative periods were not statistically significant in both groups (p > 0.05). When PRP and control groups were evaluated individually, the postoperative VAS was lower than that of preoperative VAS in both groups (p = 0.0001 and p = 0.0001, respectively).
Percutaneous PRP application significantly affected union rate, but no significant difference found when compared to EIN in the treatment of oligotrophic nonunions after intramedullary nailing of long bone fractures. PRP can be applied as a minimally invasive and safe method of saving resources in medical care instead of EIN.
本研究的目的是评估富血小板血浆对既往采用髓内钉治疗的长骨骨不连愈合率和愈合时间的影响。
2008年8月至2012年1月，连续纳入14例接受经皮富血小板血浆应用（PRP）治疗长骨骨不连的患者。对照组包括15例连续接受交锁髓内钉（EIN）治疗的患者。术后，所有患者每2周进行一次临床检查，每4周进行一次影像学检查。术前和术后采用视觉模拟评分法（VAS）对患者进行评估。
PRP组的平均愈合时间较短，为16.71±2.4周，而EIN组为19.07±3.67周（p = 0.053）。随访结束时，PRP组92.8%的病例实现了骨愈合。对照组的这一比例为80%。两组术前和术后的平均VAS值无统计学意义（p>0.05）。单独评估PRP组和对照组时，两组术后VAS均低于术前VAS（分别为p = 0.0001和p = 0.0001）。
经皮应用PRP对骨愈合率有显著影响，但在长骨骨折髓内钉固定后治疗营养不良性骨不连时，与EIN相比无显著差异。PRP可作为一种微创且节省医疗资源的安全方法替代EIN应用。
