ABSTRACT
Objective: 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]
ABSTRACT
Purpose: according to frequent needs to gastric decompression by nasogastric tube insertion during laparoscopic Cholecystectomy, the current comparative study was accomplished through single blind clinical trial considering both the presence and the absence of guide wire insertion
Materials and Methods: twenty patients were selected for elective surgery of laparoscopic Cholecystectomywith general anesthesia.Guide wires were usedin the nasogastric tube insertion operation of patients with even numberswhile the operation of patients with odd numberswas not assisted withthese guide wires.Afterwards, the considered parameters between the two groups were evaluated.The gathered data was analyzed by SPSS softwareversion 18.The results were considered statistically significant for [P = .05]
Results: the two groups were uniform regarding demographic parameters such as age, and sex [P = .05].In the group utilized guide wiresthe surgeon's satisfaction rate was higher while some other parameters such as trial score, bleeding episodes, insertion time, and Rate-Pressure Production Index were meaningfully lower than the those of the group not utilized guide wires. Also, in both groups the success rate of insertion through left nostril was statistically higher [P = .05]
Conclusion: in laparoscopic Cholecystectomy, theinsertion method of nasogastric tube with guide wires is better than not using theguide wires