Autologous platelet injection in the treatment of long bone nonunion: A prospective interventional study

Abstract

Introduction: Union of fracture is a complex process involving many systemic as well as local factors. Disturbance in any of these factors may lead to failure of process of union. This non-union is associated with increased morbidity, pain and functional disability. Autologous platelet injection at local site has been reported to be one of the effective measures in managing the cases of fracture of long bones complicated by non-union. We conducted this prospective study to know the effectiveness of autologous platelet injection at the fracture site in cases of fracture of long bones complicated by non-union. Materials and Methods: This was a prospective interventional study comprising of 30 cases of fracture of long bones complicated by non-union. The patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The patients with established nonunion after fracture femur, tibia, humerus, radius and ulna were included in this study. Patients who were treated either by, by internal fixation, bone grafting or conservatively were added in this study. Imaging was done by X-rays and if needed by computerized tomography. Imaging was done till definite evidence of union was obtained. Results: Out of 30 cases there were 18 males and 12 females with a M:F ratio of 0.66. The most common bones involved were femur (60%), tibia (16.67%) and humerus (16.67%). Combined fractures of Radius and Ulna were seen in 3 (10 %) patients. The mechanism of injury was Road traffic accidents (66.66%) followed by direct blow and fall from height. All patients initially were treated conservatively or by surgery depending upon type of fractures. Non-union of fractures were treated by autologous platelet injection. All fractures showed radiological evidence of union within 4 months of treatment. Conclusion: Autologous platelet injection at local site is an effective management strategy in patients of fracture of long bones complicated by non-union. A non-infected site is the pre-requisite of this treatment.