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Published on: May 25, 2012
Platelet-Rich Plasma Augmentation of Osteosynthesis in Femoral Neck Fractures: A Prospective Comparative Study
Adarsh Baiwal1, Saurav Mukhopadhyay1, Utkarsh Mittal1
1Department of Orthopaedics, Gandhi Medical College and Associated Hamidia Hospital, Bhopal, Madhya Pradesh, India.
Introduction:
Femoral neck fractures remain a major challenge in orthopedic trauma because the tenuous intracapsular blood supply predisposes to non-union and avascular necrosis even after mechanically sound fixation. Internal fixation is the standard head-preserving option in younger adults, yet biological failure persists. This study aimed to determine whether supplementing conventional osteosynthesis with autologous platelet-rich plasma (PRP) accelerates bone healing and improves functional recovery.
Materials And Methods:
In this prospective comparative study, 60 patients aged 18-60 years with acute femoral neck fractures were allocated equally to two groups. Group A (n = 30) underwent closed reduction and internal fixation with three cannulated cancellous screws augmented by intraoperative PRP injection through the screw cannulations; Group B (n = 30) received identical screw fixation alone. The groups were comparable in demographics, injury mechanism, and Garden and Pauwels classifications. Outcomes assessed over a minimum 1-year follow-up were time to radiological union, time to full weight-bearing, functional recovery by the Harris Hip Score (HHS), pain by the Visual Analog Scale (VAS), and post-operative complications.
Results:
PRP augmentation significantly accelerated healing. Radiological union was achieved at a mean of 3.54 ± 0.32 months in Group A versus 4.03 ± 0.47 months in Group B (P < 0.0001), permitting earlier full weight-bearing (3.58 ± 0.39 vs. 4.19 ± 0.54 months; P < 0.0001). The PRP group reached a higher final mean HHS (91.03 ± 1.38 vs. 88.73 ± 2.18; P < 0.0001). Final VAS scores did not differ significantly between groups (4.43 ± 0.50 vs. 4.70 ± 0.70; P = 0.09). Complication, non-union, and avascular necrosis rates requiring revision were low and comparable between groups.
Conclusion:
Autologous PRP is a safe and effective biological adjunct to internal fixation of femoral neck fractures. It shortens the time to union and to full weight-bearing and improves functional hip recovery without increasing surgical complications, and merits consideration as a routine addition to head-preserving osteosynthesis.