The Efficacy of Platelet-Rich Plasma in the Treatment of Rib Fractures
30 January 2016
02 March 2016
05 May 2016 (eFirst)
Background Rib fracture is the most common result of thoracic traumas. Intrapulmonary shunt, alveolar capillary membrane damage, intra-alveolar hemorrhage, and hypoxia may develop following rib fractures. Therefore, prompt treatment is important. The aim of this experimental study was to analyze the effects of platelet-rich plasma (PRP) on rib fractures to secure a speedier and more efficient treatment method.
Materials and Methods The study involved 18 New Zealand white rabbits, randomly divided into three groups as Group 1, the sham group with no surgical intervention; Group 2, the control group in which simple rib fractures were applied and no treatment; and Group 3, in which rib fractures were applied and then PRP treatment was administered.
Results The mean recovery plate thickness measurements were found to be statistically significantly higher in the PRP group compared with the other groups (p < 0.005). A thicker fibrotic cell proliferation and the formation of many capillaries were observed around the growth plate in the PRP group compared with the other groups. These structures were lesser in the control group compared with the PRP group and at the lowest level in the sham group. Larger and distinct callus formation was observed and a new intramedullary field in the PRP group.
Conclusions PRP is a reliable and effective autologous product with minimal side effects, which can be considered as an alternative treatment in patients with rib fractures and used easily in pseudoarthrosis, surgical fracture, or flail chest.
- 1 Anitua E, Sánchez M, Nurden AT, Nurden P, Orive G, Andía I. New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol 2006; 24 (05) 227-234
- 2 Athanassiadi K, Gerazounis M, Theakos N. Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg 2004; 26 (02) 373-376
- 3 Ballock RT, O'Keefe RJ. The biology of the growth plate. J Bone Joint Surg Am 2003; 85-A (04) 715-726
- 4 Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a histological and histomorphometric study on the use of autogenous scaffolds, particulate cortico-cancellous bone grafts and platelet rich plasma in goats. Int J Oral Maxillofac Surg 2004; 33 (01) 48-55
- 5 Park JB, Cho YS, Choi HJ. Diagnostic accuracy of the inverted grayscale rib series for detection of rib fracture in minor chest trauma. Am J Emerg Med 2015; 33 (04) 548-552
- 6 Kanthan SR, Kavitha G, Addi S, Choon DSK, Kamarul T. Platelet-rich plasma (PRP) enhances bone healing in non-united critical-sized defects: a preliminary study involving rabbit models. Injury 2011; 42 (08) 782-789
- 7 Kim SG, Kim WK, Park JC, Kim HJ. A comparative study of osseointegration of Avana implants in a demineralized freeze-dried bone alone or with platelet-rich plasma. J Oral Maxillofac Surg 2002; 60 (09) 1018-1025
- 8 Lyras DN, Kazakos K, Verettas D. , et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int 2009; 30 (11) 1101-1106
- 9 Mohr M, Abrams E, Engel C, Long WB, Bottlang M. Geometry of human ribs pertinent to orthopedic chest-wall reconstruction. J Biomech 2007; 40 (06) 1310-1317
- 10 Nirula R, Diaz Jr JJ, Trunkey DD, Mayberry JC. Rib fracture repair: indications, technical issues, and future directions. World J Surg 2009; 33 (01) 14-22
- 11 Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 2010; 38 (02) 255-262
- 12 Reber P, Ris HB, Inderbitzi R, Stark B, Nachbur B. Osteosynthesis of the injured chest wall. Use of the AO (Arbeitsgemeinschaft für Osteosynthese) technique. Scand J Thorac Cardiovasc Surg 1993; 27 (3–4): 137-142
- 13 Rick GS, Craig JG, Mark SC. Platelet-rich plasma: properties and clinical applications. J Lancaster Gen Hosp 2007; 2: 25-30
- 14 Yüksel S, Adanır O, Gültekin MZ. , et al. Effect of platelet-rich plasma for treatment of Achilles tendons in free-moving rats after surgical incision and treatment. Acta Orthop Traumatol Turc 2015; 49 (05) 544-551
- 15 Say F, Gürler D, İnkaya E, Bülbül M. Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthop Traumatol Turc 2014; 48 (06) 667-672
- 16 Funaki S, Inoue M, Minami M, Okumura M. Video-assisted thoracoscopic resection of fractured ribs to prevent descending aorta injury in patient with chest trauma. Ann Thorac Cardiovasc Surg 2014; 20 (02) 173-174
- 17 Simman R, Hoffmann A, Bohinc RJ, Peterson WC, Russ AJ. Role of platelet-rich plasma in acceleration of bone fracture healing. Ann Plast Surg 2008; 61 (03) 337-344