Single/ Multiple Dose Percutaneously Injected LR-PRP Enhances Union Rate in Fracture Delayed Unions: A Prospective Case Series

Indian J Orthop. 2024 Sep 10;58(12):1827-1832. doi: 10.1007/s43465-024-01265-6. eCollection 2024 Dec.

Abstract

Background: Average bone healing times of common fractures in adults ranges from 3 to 12 weeks and is location dependent. Platelet Rich Plasma (PRP) stimulates natural healing process through growth factors contained in platelets and has been employed for the same in delayed unions.

Methods: All patients > 18 years and documented delayed union were included in the study. Patients were followed up monthly after each Leucocyte-rich PRP (LR-PRP) injection and a decision for repeat PRP injection was taken on basis of visible impression in radiograph after previous injection.

Results: Total 36 patients were studied in which 5 patients were lost to follow-up. Union was achieved in 28/31 (90.3%). 20 (71.4%) patients required only single PRP injections. 4 (14.3%) patients required 2 PRP injections, 3 (10.7%) patients required 3 PRP injections and 1 (3.6%) patient required 4 PRP injection. There was no significant correlation of number of PRPs to time from 1st PRP-union or time from last PPR- union.

Conclusion: Single/multiple dose percutaneously administered LR-PRP can be used as a fruitful alternative to catalyze union in patients having delayed union irrespective of site of injury.

Keywords: Delayed union; Diaphyseal fracture; Fracture healing; LR-PRP; Metaphyseal fracture; Non-surgical treatment; PRP.