Effect of Adjuvant Steel Plate Combined with Intraoperative and Postoperative Autologous Platelet-Rich Plasma（PRP）on the Healing of Nonunion after Intramedullary Fixation of Femoral Fractures
Wang Dapeng1, Liu Jun2, Zhang Jinchu1,*
1. Department of Orthopedics and Traumatology,Songzi Traditional Chinese Medicine Hospital,Songzi Hubei 434200,China; 2. Department of Orthopedics,Jingzhou Central Hospital,Jingzhou Hubei 434000,China
Abstract：Objective To investigate the efficacy of adjuvant steel plate combined with autologous platelet-rich plasma（PRP）in patients with nonunion after intramedullary fixation of femoral fractures. Methods Thirty-eight patients with nonunion after intramedullary fixation of femoral fractures were randomly divided into a control group（n=19）and an observation group（n=19）using a random number table.The control group retained the intramedullary fixation with additional reconstructive steel plate and received intraoperative autologous iliac bone grafting.The observation group,on the basis of the control group,was treated with intraoperative and postoperative autologous PRP implantation at the bone defect site.Perioperative indicators,fracture healing,callus formation,and excellent limb recovery were compared between the two groups. Results The perioperative indicators in the observation group were all lower than those in the control group（t=5.404,4.442,2.729,P<0.05）.The fracture healing time in the observation group was shorter than that in the control group（t=3.683,P<0.05）,and the fracture healing rate at 6 months postoperatively was higher in the observation group than in the control group（χ2=6.269,P<0.05）;however,there was no significant difference in the fracture healing rate at 9 months postoperatively（χ2=1.448,P>0.05）.At 1,2,3,and 6 months postoperatively,the Fernandez-Esteve callus grade scores in the observation group were higher than those in the control group（t=6.889,5.985,4.223,5.220,P<0.05）,but there was no significant difference at 9 months postoperatively（t=1.975,P>0.05）.At 9 months postoperatively,there was no significant difference in the excellent rate of limb recovery between the two groups（χ2=1.576,P>0.05）. Conclusion The addition of intraoperative and postoperative autologous PRP to adjuvant steel plate therapy for the treatment of nonunion after intramedullary fixation of femoral fractures can significantly reduce intraoperative blood loss,shorten operative time,and effectively promote fracture healing and limb recovery.
王大鹏, 刘军, 张进初. 辅助钢板联合术中及术后自体单采PRP对股骨骨折髓内固定后骨不连愈合的影响[J]. 哈尔滨医药, 2025, 45(1): 47-49.
Wang Dapeng, Liu Jun, Zhang Jinchu. Effect of Adjuvant Steel Plate Combined with Intraoperative and Postoperative Autologous Platelet-Rich Plasma（PRP）on the Healing of Nonunion after Intramedullary Fixation of Femoral Fractures. journal1, 2025, 45(1): 47-49.
[1] Jin Y F,Xu H C,Shen Z H,et al.Comparing augmentative plating and exchange nailing for the treatment of nonunion of femoral shaft fracture after intramedullary nailing:a meta-analysis[J].Orthop Surg,2020,12(1):50-57. [2] Niu Y,Bai Y,Xu S,et al.Treatment of lower extremity long bone nonunion with expandable intramedullary nailing and autologous bone grafting[J].Arch Orthop Tr-auma Surg,2011,131(7):885-891. [3] Yin W,Qi X,Zhang Y,et al.Advantages of pure platelet-rich plasma compared with leukocyte- and platelet-rich plasma in promoting repair of bone defects[J].J Transl Med,2016,14:73. [4] 张伟,刘昊扬,唐佩福.骨不连的危险因素及风险预警模型研究进展[J].解放军医学院学报,2023,44(6):714-719. [5] 刘琴,沈先涛,徐春芬,等.自体富血小板血浆治疗儿童病理性骨折疗效观察[J].临床输血与检验,2023,25(3):354-357. [6] 吕婧,温阳阳,倘艳锋,等.辅助钢板联合富血小板血浆及自体髂骨治疗股骨骨折髓内固定后骨不连[J].实用骨科杂志,2020,26(2):174-178. [7] 许硕贵. 骨不连的临床治疗及展望[J].蚌埠医学院学报,2023,48(1):23-30. [8] 何为卫,金毅,龙禹飞,等.富血小板血浆联合植骨治疗骨不连的疗效观察[J].实用手外科杂志,2023,37(1):51-54. [9] 贺杰,李仪宁,任洪峰,等.富血小板血浆复合自体松质骨移植的生物重建治疗陈旧性腕舟状骨骨不连的临床效果分析[J].生物骨科材料与临床研究,2023,20(5):49-54.
2025, Vol. 45 
