, Volume 99, Issue 3, pp 243–248 | Cite as

Role of autologous platelet-rich plasma in treatment of long-bone nonunions: a prospective study

  • R. Malhotra
  • V. Kumar
  • B. GargEmail author
  • R. Singh
  • V. Jain
  • P. Coshic
  • K. Chatterjee
Original Article



Fracture union is a complex biological process, which depends upon several systemic and local factors. Disturbance of any of these factors may lead to nonunion of the fracture. These nonunions have a huge impact on quality of life as well as socioeconomical aspects. The platelets on activation release a number of growth factors and differentiation factors, which play important role in fracture healing. This study aimed to look for efficacy of platelet-rich plasma in the treatment of established fracture nonunions of long bones.


A total of 94 patients with established nonunion of long bone (35 tibia, 30 femur, 11 humerus, 4 radius, 12 ulna, 2 with both radius and ulna) were included in this study. We injected 15–20 ml of autologous platelet-rich plasma (>2,000,000 platelets/μl) under image intensifier at each nonunion site. The fracture union was evaluated clinically and radiologically regularly at monthly interval till 4 months.


Eighty-two patients had their fracture united at the end of 4 months. Thirty-four patients showed bridging trabeculae on X-rays at the end of 2 months, while 41 patients showed bridging trabeculae at the end of third month. Twelve patients did not show any attempt of union at 4 months and were labeled as failure of treatment. There were no complications.


Platelet-rich plasma is a safe and effective treatment for the treatment of nonunions. More studies are needed to look into molecular mechanism of this fracture healing acceleration by platelet-rich plasma.


Nonunion Platelet-rich plasma (PRP) Femur Tibia Humerus Radius 



We would like to thank Indian Council of Medical Research (ICMR) for funding this study.

Compliance with ethical standards

Conflict of interest



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Copyright information

© Istituto Ortopedico Rizzoli 2015

Authors and Affiliations

  • R. Malhotra
    • 1
  • V. Kumar
    • 1
  • B. Garg
    • 1
    Email author
  • R. Singh
    • 1
  • V. Jain
    • 1
  • P. Coshic
    • 2
  • K. Chatterjee
    • 2
  1. 1.Department of OrthopedicsAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of Transfusion MedicineAIIMSNew DelhiIndia

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