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| 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 |
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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.
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Received: 10 February 2025
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2025, Vol. 45 
