effects of platelet rich plasma on healing rate of long bone non-union fractures: a randomized double-blind placebo controlled clinical trial

To determine the effects of platelet rich plasma prp on healing rates of long bone non-union fracture. method: this was a randomized double-blind placebo controlled clinical trial being performed in a 12-month period. we included 75 adult (>18 years) patients suffering from long bone (femur, tibia, humerus and ulna) non-union fracture who were randomly assigned to receive 5ml prp (n=37) or 5ml normal saline as placebo (n=38) in the site of fracture after intramedullary nailing or open reduction and internal fixation (orif) along with autologous bone graft. patients were followed each 45 days till 9 months and were evaluated both clinically and radiologically in each visit. the healing rate, failure rate, incidence of infection, mal-union and limb shortening were recorded and compared between groups after 9 months of follow-up. results: the healing rate was significantly higher in prp group compared to placebo (81.1% vs. 55.3%; p=0.025). the limb shortening was significantly higher in those who received placebo (2.61±1.5 vs. 1.88±1.2mm; p=0.030). injection of prp was also associated with lower pain scores (p=0.003) and shorter healing duration (p=0.046). the surgical site infection (p=0.262) and mal-union rate (p=0.736) were comparable between groups. conclusion: application of prp along with autologous bone graft in the site of non-union of long bone after intramedullary nailing or orif results in higher cure rate, shorter healing duration, lower limb shortening and less postoperative pain. higher infection rate might be a complication of prp application. clinical trial registry: this trial is registered with the iranian clinical trials registry (irct201208262445n1; www.irct.ir).