Clinical Study on the Treatment of Delayed Union After Long Bone Fracture Surgery with Platelet- Rich Plasma and Intramedullary Nail Dynamization

¹ Department of Orthopedics, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei, China,

² Department of Orthopaedics, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou 511300, Guangdong, China,

BAS 2025 , 3(4), 82–89; https://doi.org/10.26689/bas.v3i4.11715

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Background: The purpose of this study was to investigate the clinical effect of platelet-rich plasma (PRP) combined with intramedullary nailing in the treatment of delayed union after long bone fracture surgery. Methods: To retrospectively analyze the clinical data of 60 patients with delayed healing of long bone fractures treated in the Department of Orthopaedics of the Fourth Affiliated Hospital of Guangzhou Medical University in 2023 from January 2021 to December 2021, patients were randomly divided into a combined treatment group (30 cases) and a control group (30 cases). PRP combined with intramedullary nail dynamic therapy was used for combined treatment, while only intramedullary nail dynamic therapy was used for the control group. Results: Bone healing was achieved in 28 patients in the combination group (93.3%), and the mean bone healing time was 4.2 ± 1.1 months. The former group was significantly better than the control group (76.7%, 6.5 ± 1.4 months) (p < 0.05). At the last follow-up, the recovery rate of limb function was 90.0% in the combined treatment group and 70.0% in the control group, and the former had an advantage in this aspect (p < 0.05). No disability or death occurred during follow-up in either group. Conclusion: PRP combined with intramedullary nailing has a significant clinical effect on delayed union after long bone fracture surgery, which can effectively promote fracture healing and improve patient prognosis.

References

Fang J, Zhang X, Chen X, et al., 2023, The Role of Insulin-Like Growth Factor-1 in Bone Remodeling: A Review. Int J Biol Macromol, 238: 124125.

[missing author], 2004, Chinese Translation of “AO Principles of Fracture Management.” Chinese Journal of Traumatology & Orthopaedics, 2004(5): 126.

Healy W, White G, Mick C, et al., 1987, Nonunion of the Humeral Shaft. Clin Orthop Relat Res, 1987(219): 206–213.

Hak D, Fitzpatrick D, Bishop J, et al., 2014, Delayed Union and Nonunions: Epidemiology, Clinical Issues, and Financial Aspects. Injury, 45 Suppl 2: S3–S7.

Van Lieshout E, Den Hartog D, 2021, Effect of Platelet-Rich Plasma on Fracture Healing. Injury, 52 Suppl 2: S58–S66.

Le A, Enweze L, Debaun M, et al., 2018, Current Clinical Recommendations for Use of Platelet-Rich Plasma. Curr Rev Musculoskelet Med, 11(4): 624–634.

Zhang X, Fu C, 2025, Research Progress of Platelet-Rich Plasma in Orthopedic Treatment – A Bibliometric Analysis Based on CiteSpace 6.4.R1. Heilongjiang Science, 16(2): 73–75 + 79.

Hu M, Zeng W, Zhang J, et al., 2023, Fixators Dynamization for Delayed Union and Non-Union of Femur and Tibial Fractures: A Review of Techniques, Timing, and Influencing Factors. J Orthop Surg Res, 18(1): 577.

Vicenti G, Bizzoca D, Carrozzo M, et al., 2019, The Ideal Timing for Nail Dynamization in Femoral Shaft Delayed Union and Non-Union. Int Orthop, 43(1): 217–222.

Perumal R, Shankar V, Basha R, et al., 2018, Is Nail Dynamization Beneficial After Twelve Weeks – An Analysis of 37 Cases. J Clin Orthop Trauma, 9(4): 322–326.

Pesciallo C, Garabano G, Alamino L, et al., 2022, Effectiveness of Nail Dynamization in Delayed Union of Tibial Shaft Fractures: Relationship Between Fracture Morphology, Callus Diameter, and Union Rates. Indian J Orthop, 56(3): 386–391.

Glatt V, Evans C, Tetsworth K, 2016, A Concert Between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing. Front Physiol, 7: 678.

Wang J, Chi Y, Yang B, et al., 2022, The Application of Biomaterials in Osteogenesis: A Bibliometric and Visualized Analysis. Front Bioeng Biotechnol, 10: 998257.

Dülgeroglu T, Metineren H, 2017, Evaluation of the Effect of Platelet-Rich Fibrin on Long Bone Healing: An Experimental Rat Model. Orthopedics, 40(3): e479–e484.

Wang L, Yang J, Zhang B, et al., 2020, Platelet-Rich Plasma Injection for the Treatment of Atrophic Fracture Nonunion. Zhongguo Gu Shang, 33(3): 261–264.

Li S, Xing F, Luo R, et al., 2021, Clinical Effectiveness of Platelet-Rich Plasma for Long-Bone Delayed Union and Nonunion: A Systematic Review and Meta-Analysis. Front Med (Lausanne), 8: 771252.

Yu T, Pang J, Wu K, et al., 2015, Platelet-Rich Plasma Increases Proliferation of Tendon Cells by Modulating Stat3 and p27 to Up-Regulate Expression of Cyclins and Cyclin-Dependent Kinases. Cell Prolif, 48(4): 413–420.

Previous article in this issue

Next article in this issue