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Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

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  • Open Access

Autologous platelet gel for delayed union of tibial shaft treated with intramedullary nailing

  • S. Flamini1,
  • A. Di Francesco1Email author,
  • O. Colafarina1,
  • P. Cerulli Mariani1,
  • R. Pizzoferrato1 and
  • A. Rughetti2
Journal of Orthopaedics and TraumatologyOfficial Journal of the Italian Society of Orthopaedics and Traumatology20078:153

Received: 24 February 2006

Accepted: 18 January 2007

Published: 5 March 2007


Early recognition of a potential nonunion followed by early intervention reduces the ultimate time to union, and lessens the frustration for both patient and surgeon. The aim of this study was to evaluate the efficacy of treatment with autologous platelet gel (PG), rich in growth factors, in the treatment of delayed unions of tibial shaft fractures treated with locked intramedullary nailing. We treated 15 atrophic delayed unions of unstable tibial shaft fractures, stabilized with locked intramedullary nail. The mean time between the acute treatment of the fracture and PG application was 151 days. PG was injected into the site of unhealed fracture during closed surgery. The planned treatment programme was 3 radio-guided applications of PG at intervals of 3–4 weeks. Clinical and radiological evaluations 2, 4 and 6 months after the first application of PG showed gradual improvement of the clinical picture and progressive formation of bone callus. In almost all cases there were clinical and radiological improvements and it was possible to remove the synthesis aid an average of 12 months after the start of the therapeutic programme.

Key words

Delayed unionTibiaPlatelet gelNailing